Treatment

Eli Lilly Insulin Price Cap Program

Lilly’s easy-to-enroll program limits co-pays to $35/month for most people and could start a market share war among the big 3 insulin producers

Both the government and BigPharma have been under increasing pressure to lower the price of insulin — which has increased by more than 1200 percent in the last 20 years. 

“Back in 1996, when Eli Lilly’s Humalog first came out, the price for a 1-month supply of insulin was $21. As of 2001, that exact vial’s price increased by $14 to $35. Now, in 2019, that vial is said to be around $275,” explains one of many articles aimed at the increasing greed of BigParma. 

Novo Nordisk, Sanofi, and Eli Lilly manufacture today’s best insulin options, including Novolog, Humalog, Fiasp, Levemir, Lantus, Tresiba, and Toujeo. 

One by one, thanks to pressure from patients and supporters across the globe, these pharmaceutical giants are offering copay price-cap programs for people with or without insurance, regardless of your personal monthly income which is a typical obstacle in their previous savings programs.

Lilly’s $35 copay: The “Lilly Insulin Value Program”

Lilly announced a “price-cap” program on insulin several months after receiving criticism in late 2019 for still failing to lower prices as they had previously promised.

“Anyone who has commercial insurance, or no insurance, can purchase their monthly prescription of Lilly insulin for $35 through the Lilly Insulin Value Program,” explains the press release.

The program is effective immediately and covers most Lilly insulins, including Humalog and non-branded insulins.

Mike Mason, the President of Lilly Diabetes, said they increased effort to lower insulin prices due to the COVID-19 crisis. 

“Too many people in the U.S. have lost their jobs because of the COVID-19 crisis, and we want to make sure no one goes without their Lilly insulin,” Mason said in a statement in early March.

“We’ve been providing affordability solutions for a long time, but more is needed to help people during this unprecedented period. People with commercial insurance, as well as those without insurance at all, are eligible, and the process is quick and simple. We want people who need help to call us,” he added.

You are eligible if:

  • You have commercial insurance
  • You do NOT have commercial insurance

You are not eligible if:

  • You are currently enrolled in Medicare Part D

If you are not eligible, you should still call the program phone number to learn if you may qualify for other Lilly financial assistance programs.

How to enroll in Lilly’s Insulin Value Program:

  • Call the Lilly Diabetes Solution Center at 833-808-1234 
  • Open Monday through Friday, 8 a.m. to 8 p.m.

“The calls are simple, the average time on the phone is about 10 minutes, and there’s no paperwork to fill out,” explains DeShong Perry-Smitherman, communications manager for Lilly Diabetes. “We have operators who can take calls in Spanish and we can translate information into about 40 languages.”

You will give them information including your name, address, and insurance details if applicable.

Lilly Diabetes will then send a copay card to your address that you should bring with you to the pharmacy when you fill your next insulin prescription.

If you are enrolled in Medicare Part D

Fortunately, even though this new copay program isn’t applicable for those on Medicare Part D, there are other programs in development to help you cut insulin costs in a similar fashion.

The Trump administration also announced a program for Medicare Part D enrollees to pay no more than $35 per month for insulin regardless of their deductible, coverage or a gap in coverage.

Other insulins…

Mannkind manufactures Afrezza, an inhaled insulin that can serve as a worthwhile alternative for some or all of a person’s fast-acting insulin needs. Afrezza also offers a savings program but tends to be far less expensive than traditional insulin in the first place.

Afrezza has continued to be one of the more affordable options but not necessarily an ideal alternative for everyone. 

You should try Afrezza for yourself and see. Some folks love it, some don’t.

Walmart also sells archaic yet affordable insulins “Regular” and “NPH,” which sell without a prescription for only $25, but they are cheap for a reason, and certainly not considered the standard of care those of us with diabetes expect today for the sake of our longterm health.

Hopefully, other insulin manufacturers will follow suit and the overall out-of-pocket cost of insulin will lower as patients continue to speak up about the outrageous rising prices. 

Market Share Ploy by Lilly?

For decades, BigPharma and their co-conspirators, Pharmacy Benefit Managers, seem to have played a coordinated shell game of increasing list prices and PBM rebates that cost patients more and more.

The move by Lilly could signal a change in this pattern.  We imagine that Lilly sees an opportunity to switch many patients to its insulin and permanently increase its share if the US insulin market.  If this is their motivation, we should hope for similar programs from Novo Nordisk and Sanofi to protect their US revenues.

Update

Playing catch-up, Novo Nordisk has quickly come up with their own offering just days after Lilly’s $35 copay price-cap, with the offer of free Novo Nordisk insulin for anyone who has recently lost their health insurance due to COVID-19-related unemployment. This would include Novolog, Fiasp, and Tresiba. The free insulin is available for up to 90 days through their Patient Assistance Program.

Unlike Lilly, the Novo Nordisk program is temporary.

“Applicants are not required to provide documented proof of income,” explains the announcement. “Participants must provide documentation showing loss of healthcare benefits, such as a job termination notice or job status change, or proof that COBRA benefits are being offered. In addition, if Medicaid benefits are denied, assistance for eligible patients can be extended past the 90-day-window until the end of the year. People applying for this program must have a valid prescription for a Novo Nordisk insulin and meet certain eligibility criteria, which can be found on NovoCare.com or by calling 1.844.NOVO4ME (668.6463).”

Here is the press release from Novo Nordisk.

Ginger Vieira has lived with Type 1 diabetes and Celiac disease since 1999, and fibromyalgia since 2014. She is the author of 4 books: Pregnancy with Type 1 Diabetes, Dealing with Diabetes Burnout, Emotional Eating with Diabetes, Your Diabetes Science Experiment. Ginger creates content regularly for Diabetes Strong, Healthline, HealthCentral, DiabetesDaily, EverydayHealth and her YouTube Channel. Her background includes a B.S. in Professional Writing, certifications in cognitive coaching, Ashtanga yoga, and personal training with several records in drug-free powerlifting. She lives in Vermont with two kiddos and two dogs.

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