The DPAC Diabetes Policy Handbook exists to help policymakers, advocates, and the community identify state and national tools to consider replicating to combat diabetes and its risk factors. The condition is at pandemic-level proportions as 11% of Americans are diagnosed with either type 1 or type 2 diabetes, and another 40% live with prediabetes or are undiagnosed. Amid long-standing commitments to public health departments and legislative advancements such as copayment limitations, increased price transparency and coverage mandates, the question we are most often asked by key leaders: What else can we do?
This page offers state policymakers models which would improve patients' access and affordability, and solutions that deliver economic benefits.
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The Kentucky Prescription Assistance Program (KPAP) enables and expands community-based efforts to enroll eligible individuals in reduced cost prescription programs presently offered by manufacturers, retailers and other sponsors.
Run by just a few full-time employees and contractors to keep the program lean and mean, KPAP connects Kentuckians with resources to reduce prescription costs, offering more direct access to the treatment they need to live. By partnering with individuals and organizations already active in underserved communities – including county health departments, hospitals, food pantries and faith-based organizations — KPAP can expand its capacity to all 120 counties without duplicating efforts. Today, KPAP is helping more than 4,800 Kentuckians access $47 million in free and reduced-cost medications in a single year. KPAP's efficient deployment of its annual $600K appropriation may make it the only state program across the nation to deliver a 78-times return on investment.
Arkansas has passed legislation requiring its Medicaid program to include diabetes technology to ensure low-income residents have comprehensive coverage.
Continuous glucose monitors (CGM)offer people with diabetes an essential tool to keep their blood glucose levels within a recommended range. By helping patients make prompt adjustments to manage their condition, these devices also mitigate avoidable complications that could cost Medicaid thousands. One study shows that patient adoption of CGMs for just nine months results in healthcare costs savings of $4,000 compared to a patient without a CGM.
While federal laws and regulations set standards for coverage under Medicaid, individual states may determine the finer points of what is and is not covered, and how programs are administered. By including tools like CGMs under Medicaid, a state may safeguard its most vulnerable residents while effectively managing its financial resource
Below is a map offering summary statistics on how diabetes impacts each state and what, if any, policy measures have been taken by a state to address the epidemic. We specifically highlight:
Legislative Caucuses focused on diabetes
Diabetes action plans,
Insulin copay caps,
Diabetes supply copay caps,
Rebate pass-through,
First-dollar coverage for diabetes care,
Comprehensive Medicaid coverage for CGMs,
Copay Accumulator Adjustment Program Bans
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