New Express Scripts Program Caps Insulin Costs for 30-Day Supplies at $25

Insulin bottled labeled next to syringe

The increasing price of insulin has been a concern for diabetic patients, providers and lawmakers for some time.

Last year, Minnesota Attorney General Lori Swanson filed a lawsuit against three of the biggest insulin manufacturers over price gouging claims. In the lawsuit, Swanson said Eli Lilly, Sanofi and Novo Nordisk “deceptively raise the list price of insulin” and that the hikes have made the life-saving medication “less affordable.” Then, in November 2018, the American Diabetes Association published recommendations and public policy solutions to address the problem of affordable insulin. The ADA’s call-to-action was based on data that showed the average price of insulin nearly tripled between 2002 and 2013.

In January, another report was released that highlighted the price increase for the life-saving medication. A cost analysis for insulin was released by the nonprofit Health Care Cost Institute that showed the price of insulin doubled between 2012 and 2016. As a result of mounting public outrage, as well as Congressional inquiries into the rising costs, last week Cigna and Express Scripts launched the Patient Assurance Program, which will ensure eligible people with diabetes in participating plans pay no more than $25 for a 30-day supply of insulin. In 2018, the average out-of-pocket cost for insulin for Cigna members was $41.50 for a 30-day supply. The new program will save those served by Cigna and Express Scripts an average of 40 percent. Individuals with plan designs that involve coinsurance and/or a high deductible will benefit the most from this new program, the companies said in their announcement.

Steve Miller, chief clinical officer of CIGNA Corporation, said insulin is as essential as air for diabetes patients.

“We need to ensure these individuals feel secure in their ability to afford every fill so they don’t miss one dose, which can be dangerous for their health. Together, Cigna and Express Scripts are now able to give people who rely on insulin greater affordability and cost predictability so they can focus on what matters most: their well-being,” Miller said in a statement.

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The new Patient Assurance Program is available to members who participate in non-government funded healthcare plans that are managed by Express Scripts, which includes Cigna and others. The companies said that in the majority of cases, people who use insulin will see lower out-of-pocket costs without any increased cost to the plan. Miller said the new program will remove cost as a barrier for people who either ration the medication or skip it altogether, which endangers their health. A recent Yale study highlighted the effects of this issue, showing that one in four people with diabetes who use insulin admitted to cutting back on the use of insulin because of cost.

“Better care and better outcomes are rooted in greater choice, affordability, and access, and we can bring all of these to people with the greatest needs,” he said.

The pressures over insulin prices seem to be having an effect on drugmakers as well. In March, Eli Lilly announced it will start selling an “authorized generic” version of its popular Humalog 100 at about 50 percent off the list prices. The price will be $137.35 per vial. Diabetes patients typically use two vials per month. The new product will be branded Insulin Lispro and sold through ImClone Systems, a Lilly subsidiary. Also in March, Eli Lilly disclosed data over the weekend that indicates the price for its lead insulin product Humalog dropped by 8 percent over the past five years.

Last year, Eli Lilly also opened its Lilly Diabetes Solution Center to assist people who need help paying for their Lilly insulin. The company said it has provided assistance to more than 10,000 people per month since the company established the center in August 2018.

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