ATLANTA — America leads the world in expenses for prescription medications. In the late 1990s, pharmaceutical companies started raising the prices of their drugs and it's costing Americans their lives – many are forced to choose between quality of life or death.
11Alive's #CostofCare series focuses on the issues and challenges people face in the U.S. healthcare system after receiving a life-changing medical diagnosis. Here are their stories.
In the U.S., there are three insulin manufacturers who dominate the market: Eli Lilly, Novo Nordisk and Sanofi. Below are their statements in response to 11Alive's inquiry about rising medication prices and when patients cannot afford to buy life-saving medication:
Lilly is committed to making insulin affordable for all people living with diabetes, regardless of income or insurance status. In the past years, we introduced multiple solutions that have progressively lowered the out-of-pocket cost for Lilly insulin. Today, anyone is eligible to purchase their Lilly insulin prescription for $35 or less per month, regardless of the number of pens or vials they use, and whether they are uninsured or use commercial insurance, Medicaid, or are enrolled in a participating Medicare Part D plan.
The fact is that our solutions are making a real impact for people with diabetes. Despite rising deductibles, the average monthly out-of-pocket cost for Lilly insulin has dropped by 44 percent, to $21.80, over the last five years. Lilly has not increased list prices for any of our insulins since 2017 and continues to take steps to help lower out-of-pocket costs.
Lilly advocates for comprehensive solutions and public policies, such as passing through rebates directly to people who use insulin and limiting out-of-pocket costs, to move the U.S. healthcare system from a series of patchwork solutions to systemic change that helps people access and afford their insulin, and other lifesaving drugs. None of our insulins’ active ingredients are patent protected, and we are not using patents to keep new entrants out of the insulin market. Lilly supports the use of generics and biosimilars to enter the market when patents rightfully expire. We also support removing regulatory barriers to allow such entry.
Until gaps in the healthcare system are filled, Lilly will continue to provide affordability solutions to people who need them. Anyone paying more than $35 per month for Lilly insulin can call the Lilly Diabetes Solution Center at (833) 808-1234 or go to insulinaffordability.com to learn more about our insulin affordability solutions.
Additional facts on our Insulin Affordability Programs (also found on insulinaffordability.com).
No one should go without their insulin. Lilly has meaningful programs that provide affordable insulin options to help people get the medicine they need.
In the past years, Lilly has introduced multiple solutions that allow people to purchase a monthly prescription of Lilly insulin for $35 or less, including:
- In 2020, we announced the Lilly Insulin Value Program, a co-pay card allowing people with commercial insurance or uninsured to buy their monthly prescription of Lilly insulin for $35. There is no application or enrollment process; interested individuals need only confirm they are over 18, a U.S. resident, and not covered by a government insurance program, and in a matter of seconds they will receive a PDF that they can download to their mobile device or print and present when they pick up their insulin prescription.
- Lilly and other manufacturers are contributing $250 million over five years to make our insulins available in the Senior Savings Model, allowing seniors in a participating Part D insurance plan to purchase their monthly prescription of Lilly insulin for $35.
- Lilly pays a 100 percent rebate to state governments to make our insulins available to millions of people in the Medicaid and VA programs.
- In January of 2022, we lowered the list price of our non-branded insulin, Insulin Lispro, to 70 percent off the list price of its branded counterpart, effectively bringing the list price down to 2008 level. Insulin Lispro is the same molecule as branded Humalog. Please see this page for more information on pricing https://esg.lilly.com/social.
The US healthcare system is very complex with players across the entire supply chain influencing market dynamics. Overall, net prices for insulins continue to decline due in large part to the significant rebates and discounts manufacturers pay to ensure access for patients. Net prices for Novo Nordisk Insulins in the US have continued to decline over the past 5 consecutive years.
However, we know there are people who continue to struggle to afford their insulin and that not one single solution will work for everyone. Regardless of insurance, there are many different situations that make insulin unaffordable or inaccessible, and people need options. We also recognize that people’s situation may change throughout the year, which is why we have a number of different affordability offerings available through NovoCare. Importantly, Novo Nordisk will continue to listen and assess to help us understand emerging patient needs. For example, during the pandemic we created a COVID-19 Patient Assistance Program which is still in place today.
For background, approximately 100,000 patients receive free insulin every year and in 2021, more than one million people used some form of Novo Nordisk assistance when buying our insulins. Much of that came in the form of patient copay support, where the use of such tools has become more important since health insurance benefits increasingly require patients to pay more for their insulin. We have seen meaningful uptake of our My$99Insulin program and unbranded biologics. And the feedback we see online has been overwhelmingly positive.
We also want to point out that we do have a Walmart offering that has been extended recently, which includes a human insulin program for about $25 per vial.
We encourage anyone in need to go to NovoCare.com to learn more.
“Despite rhetoric about skyrocketing insulin prices, the net price (meaning the amount that Sanofi actually receives from a sale of its medicine after payment of any rebates or discounts on such sale) of insulin has fallen for seven consecutive years, making our insulins significantly less expensive for insurance companies.
PBMs have demanded rebates for pharmaceutical products for nearly two decades, and they are an engrained feature of our healthcare system. Since 2012, the net price of our insulins declined by 54%. Over the same period, the net price for commercial and Medicare Part D plans of our most prescribed insulin, Lantus, has fallen 62%, while average out-of-pocket costs for patients with commercial insurance and Medicare has risen approximately 60%. For all the focus by health plans and others on the growth of list prices, today, the average net price of Lantus is below 2004 levels.”
“Sanofi is continuously evaluating its programs – particularly its savings programs – to ensure we are meeting the needs of as many people living with diabetes as possible. Cost should never be the reason people cannot access these life-saving medicines.”
Sanofi has a suite of innovative and patient-centric savings programs to help people reduce their prescription medicine costs:
100% of commercially insured people are eligible for co-pay assistance programs, regardless of income or insurance plan design, which limits out-of-pocket expenses for a majority of people to between $0 and $10. These programs are available for those prescribed Apidra, Insulin Glargine U-100, Lantus, Soliqua 100/33, and Toujeo.
100% of uninsured people are eligible for the Insulins Valyou Savings Program – regardless of income level – enabling them to buy one or multiple Sanofi insulins (Lantus, Insulin Glargine U-100, Toujeo, Admelog, and Apidra) at $35 for a 30-day supply. Soliqua 100/33’s cash offer also allows uninsured people to pay as little as $99 per box of pens, for up to two boxes of pens for a 30-day supply.
We also provide free medications to qualified low- and middle-income patients through the patient assistance component of the Sanofi Patient Connection program. Some people facing an unexpected financial hardship may be eligible for a one-time, immediate month’s supply of their Sanofi medicine as they wait for their application to process.
Sanofi is also part of the Centers for Medicare and Medicaid Services’ (CMS) Senior Savings Model which allows patients enrolled in participating Part D plans to pay a $35 or less co-pay for each 30-day prescription of a Sanofi insulin.