Eli Lilly caps out-of-pocket cost for insulin at $35 a month

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Eli Lilly has announced that it is reducing the list price of its insulin by 70% and capping out-of-pocket costs at $35 a month as part of its Insulin Value Program. Effective immediately, Lilly will automatically cap out-of-pocket costs at $35 at participating retail pharmacies for people with commercial insurance using Lilly insulin.

Lilly is cutting the list price of its non-branded insulin, Insulin Lispro Injection 100 units/mL, to $25 a vial. Effective May 1, 2023, it will be the lowest list-priced mealtime insulin available, and less than the price of a Humalog® vial in 1999, the company said.

It is cutting the list price of Humalog insulin lispro injection, 100 units/mL1, Lilly's most commonly prescribed insulin and Humulin (insulin human) injection 100 units/mL2 by 70%, effective in Q4 2023.

It is launching RezvoglarTM (insulin glargine-aglr) injection, a basal insulin that is biosimilar to, and interchangeable with, Lantus (insulin glargine) injection, for $92 per five pack of KwikPens, a 78% discount to Lantus, effective April 1, 2023.

Lilly chair and CEO David A. Ricks said, "We are driving for change in repricing older insulins, but we know that seven out of 10 Americans don't use Lilly insulin. We are calling on policymakers, employers and others to join us in making insulin more affordable." 

WHAT'S THE IMPACT? REACTION

The Biden Administration and organization are calling on other drug manufacturers to do the same. 

President Joe Biden said, "For far too long, American families have been crushed by drug costs many times higher than what people in other countries are charged for the same prescriptions. Insulin costs less than $10 to make, but Americans are sometimes forced to pay over $300 for it. It's flat wrong. Last year, I signed a law to cap insulin at $35 for seniors and I called on pharma companies to bring prices down for everyone on their own. Today, Eli Lilly did that. It's a big deal, and it's time for other manufacturers to follow."

U.S. Department of Health and Human Services Secretary Xavier Becerra said, "President Biden's leadership on drug pricing is having a ripple effect across America. Now it's time for other drug manufacturers to join in. And it's time for Congress to build on, not repeal, our new prescription drug law, the Inflation Reduction Act." 

The American Diabetes Association's CEO, Chuck Henderson also called upon other manufacturers to cap their prices. "While we have been able to help achieve significant progress on the issue of insulin affordability, including Medicare's new out-of-pocket cost cap on insulin, state copay caps, and patient assistance developments from insulin manufacturers, we know that our work is not done," Henderson said.

THE LARGER TREND

Earlier this year, HHS issued a new report showing the major savings coming to roughly 1.5 million people in Medicare thanks to the $35 cap on a month's supply of insulin through the Inflation Reduction Act. 

The report also found that nationally, the average out-of-pocket cost was $58 per insulin fill in 2019, typically for a 30-day supply. Patients with private insurance or Medicare paid about $63 per fill on average, and one in five Americans taking insulin paid more than $70 per prescription, the report said.

The insulin provisions of the Inflation Reduction Act went into effect January 1, for Medicare Part D.  Starting July 1, under Medicare Part B, beneficiary cost sharing will be limited to $35 for a month's supply of insulin

ON THE RECORD 

"While the current healthcare system provides access to insulin for most people with diabetes, it still does not provide affordable insulin for everyone and that needs to change," said Ricks. "The aggressive price cuts we're announcing today should make a real difference for Americans with diabetes. Because these price cuts will take time for the insurance and pharmacy system to implement, we are taking the additional step to immediately cap out-of-pocket costs for patients who use Lilly insulin and are not covered by the recent Medicare Part D cap."

Twitter: @SusanJMorse
Email the writer: SMorse@himss.org