ADA Hawaii presents national survey showing insulin cost pressures, step-therapy delays and CGM access gaps

At a Nov. 14 American Diabetes Association event in Honolulu, ADA Hawaii Executive Director Naomi Manuel presented highlights from a national ADA survey on access and affordability of diabetes care, saying the association will press for policy changes to reduce costs and expand access to technologies.

Manuel said the Hawaii survey response was not statistically significant, so the presentation focused on national results. "More than half of households spend over $200 a month on diabetes care," she said, and "29 percent have rationed, delayed, or skipped insulin or treatment in the last year due to cost." The survey also found about 42 percent of respondents enrolled in Medicare, 38 percent in employer plans and roughly 32 percent participating in assistance programs.

Panel members and presenters emphasized that out‑of‑pocket costs and insurer policies continue to be major barriers. Manuel summarized other survey findings: "For almost 50 percent of our respondents, treatment has been delayed due to step therapy and 28 percent have been denied a prescribed diabetes device." She framed those figures as a policy priority for the ADA, noting recent state-level wins on step‑therapy limits.

On technology access, Manuel previewed ADA advocacy this year to improve access to continuous glucose monitors (CGMs): "We will have some legislative, bills and actions this year, to improve access to CGMs." Panelists backed the emphasis on CGMs as both clinical and educational tools; though they cautioned insurers on cost, clinicians said wider availability can change patient behavior and reduce acute events.

The presentation reiterated ADA priorities: lower insulin costs, remove unnecessary insurer barriers such as fail‑first policies, and expand access to diabetes technologies and education. Manuel closed by asking attendees to join local advocacy and use ADA resources to press for changes in benefit design and state policy.

What happens next: ADA Hawaii said it will continue advocacy on insulin affordability and device access and invited attendees to use the State of Diabetes toolkit and to contact ADA Hawaii for volunteer or advocacy opportunities. A follow-up survey and toolkit link will be sent to attendees.