By: Urooj K. Malik, PharmD Candidate c/o 2024

March 1, 2023 marked a substantial milestone in the United States’ (U.S.’) fight for affordable insulin. Eli Lilly and Company (Lilly) has announced that over the next few months, they will be reducing the price of multiple insulin products as well as capping patient out-of-pocket costs at $35 or less per month.¹ 

Starting May 1st, the list price of Lilly’s non-branded insulin, Insulin Lispro Injection 100 units/mL, will be reduced from $82 to $25 a vial, resulting in it being the lowest list-priced mealtime insulin on the market.² Additionally, the company will be lowering the list price of its most commonly prescribed insulin, Humalog® 100 units/ml (insulin lispro), by 70% in the fourth quarter of 2023. Humulin® 100 units/mL (insulin human) will also have its price cut by 70%.¹ 

David Ricks, Lilly’s Chair and CEO, has acknowledged the significance of the company’s decision to slash prices. “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,” he proclaimed. “The aggressive price cuts we’re announcing today should make a real difference for Americans with diabetes.” ¹

Lilly’s decision to update their Lilly Insulin Value Program to limit monthly insulin costs to $35 is also major. The program now offers a savings card that covers 30-day supplies of all Lilly insulins at a maximum cost of $35 for both insured and uninsured patients.³ However, patients who have government-funded insurance programs such as Medicare or Medicaid are not eligible. The offer is also good for up to 12 calendar months, meaning that patients who benefit from the program may need to find alternative sources of affordable insulin in the future.³

Lilly’s announcement comes in response to the rapidly growing issue of American insulin prices, which have been skyrocketing at a rate exceeding the rate of inflation.⁴ According to the American Diabetes Association, the average cost of insulin nearly tripled between 2002 and 2013, making it increasingly difficult for people with diabetes to afford the medication they need to stay healthy. High costs of insulin are associated with inappropriate attempts to ration the medication; this nonadherence can lead to potentially fatal outcomes such as ketoacidosis.⁵ 

In an effort to tackle this issue, several U.S. states have implemented insulin cost caps. As of now, 22 states and the District of Columbia have capped copayments on insulin, devices, and diabetes supplies.⁶ In 2022, Maryland and Louisiana were the most recent states to pass laws with a $30 cap and $75 cap respectively for a 30-day supply.⁶ These caps limit the amount that patients have to pay for insulin, regardless of the list price set by the manufacturer. Last year, President Biden passed the Inflation Reduction Act (IRA) which capped out-of-pocket costs for insulin at $35 for patients covered under Medicare Part D or Medicare Advantage plans. Patients whose insulin covered under Part B will benefit from a similar cap beginning in July 2023.⁷

Researchers have estimated that 1.5 million people under Medicare would have benefitted from the IRA insulin cost cap if the legislation was in effect back in 2020.⁸

President Biden released a statement in support of Lilly shortly after the company’s major announcement. In this statement, Biden says “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.”⁹

Decreasing prices of insulin products and introducing price caps are not the only methods of lowering monthly costs for diabetic patients; the application of biosimilars in treatment has been considered. Mylan Pharmaceutical’s Semglee® (insulin glargine-yfgn), a substitute for Lantus® (insulin glargine), was the first interchangeable biosimilar product for diabetes to gain approval by the Food and Drug Administration (FDA) in July of 2021.¹⁰ Biosimilars marketed in the U.S. tend to launch with initial list prices lower ranging from 15% to 35% than their reference products’ list pricing.¹⁰ Lilly plans on following in Mylan’s footsteps. The release of the company’s own biosimilar, Rezvoglar™ (insulin glargine-aglr) injection, as an alternative to Lantus is set to occur on April 1, 2023. A five-pack of Rezvoglar KwikPens® will be sold for $92 – a 78% discount when compared to Lantus’ current list price.¹ Increasing availability of insulin products will assist in widening access and bringing down the cost of insulin for diabetes patients.¹⁰

Lilly intends on launching a nationwide public awareness campaign in the coming weeks to educate their consumers on accessing their company’s affordability solutions. Ricks has affirmed that the company will continue to make decisions with the wellbeing of patients in mind, declaring that “our work to discover new and better treatments is far from over. We won’t stop until all people with diabetes are in control of their disease and can get the insulin they need.” ¹

References

1. Lilly Cuts Insulin Prices by 70% and Caps Patient Out-of-Pocket Costs at $35 Per Month. Eli Lilly & Co. Published March 1, 2023. https://investor.lilly.com/news-releases/news-release-details/lilly-cuts-insulin-prices-70-and-caps-patient-insulin-out-pocket.
2. How much should I expect to pay for Lilly Non-Branded Insulin? Eli Lilly & Co. Published December 2022. https://www.lillypricinginfo.com/insulin-lispro.
3. Lilly Insulin Value Program. Eli Lilly & Co. Published February 2023. https://www.insulinaffordability.com.
4. Rajkumar S. The High Cost of Insulin in the United States: An Urgent Call to Action. Mayo Clinic Proceedings. Published January 1, 2020. https://www.mayoclinicproceedings.org/article/S0025-6196(19)31008-0/fulltext#tables.
5. Schneider R. Rationing Insulin? Why You Shouldn’t. Fransican Health. Published October 21, 2022. https://www.franciscanhealth.org/community/blog/insulin-rationing.
6. State Insulin Copay Caps. American Diabetes Association. Accessed April 12, 2023. https://diabetes.org/tools-support/insulin-affordability/state-insulin-copay-caps.
7. Sayed B, Finegold K, Olsen T, et al. Insulin Affordability and the Inflation Reduction Act: Medicare Beneficiary Savings by State and Demographics. Assistant Secretary for Planning and Evaluation. Published January 24, 2023. https://aspe.hhs.gov/sites/default/files/documents/bd5568fa0e8a59c2225b2e0b93d5ae5b/aspe-insulin-affordibility-datapoint.pdf.
8. Yoest C. New HHS Report Finds Major Savings for Americans Who Use Insulin Thanks to President Biden’s Inflation Reduction Act. U.S. Department of Health & Human Services. Published January 24, 2023. https://www.hhs.gov/about/news/2023/01/24/new-hhs-report-finds-major-savings-americans-who-use-insulin-thanks-president-bidens-inflation-reduction-act.html.
9. Statement from President Joe Biden on Action to Lower Insulin Costs [statement release]. The White House. Published March 1, 2023. https://www.whitehouse.gov/briefing-room/statements-releases/2023/03/01/statement-from-president-joe-biden-on-action-to-lower-insulin-costs/.
10. McKinney J. FDA Approves First Interchangeable Biosimilar Insulin Product for Treatment of Diabetes. U.S. Food & Drug Administration. Published July 28, 2021. https://www.fda.gov/news-events/press-announcements/fda-approves-first-interchangeable-biosimilar-insulin-product-treatment-diabetes.

Published by Rho Chi Post