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How To Get Help With Insulin Cost

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The Role Of Pharmacy Benefit Managers

Prices are also driven up through the use of pharmacy benefit managers . PBMs are companies that create and manage the lists of prescription medications that insurance companies cover. These lists are called formularies.

PBMs give priority to prescription manufacturers that offer large rebates. Manufacturers that offer large rebates are placed on more formularies and are favored by insurance companies.

More expensive prescriptions can offer larger rebates because their starting costs are so high. This has driven the price of insulin up dramatically.

Sanofi Patient Assistance Connection

The Sanofi Patient Assistance Connection provides free Sanofi insulin products to people with an income at or below 400 percent of the federal poverty level.

The program is open to Medicare Part D enrollees and people without insurance. Youll need to reapply for this program every year.

Manufacturers also offer copay savings cards. These cards can help reduce the amount you pay out of pocket for your insulin. Unlike patient assistance programs, copay savings cards are available regardless of your income.

Its worth noting that Medicare enrollees cant use copay coupons or drug cards.

  • Novo Nordisk offers a savings card that reduces the copayments for its products. Your exact savings will depend on the insulin your doctor prescribed, but copayments when using the card range between $5 and $25.
  • Eli Lilly. Eli Lilly offers the insulin value program. With the program, you can get most Eli Lilly insulin products for $35 per month. You can use the program with or without insurance, and there are no income limits.
  • Sanofi. The Sanofi copay savings card is for people with insurance. It reduces copayments for Sanofi insulin to between $0 and $10. Those without insurance can join the Valyou Savings Program, which allows people to purchase Sanofi insulin for $99 per month.

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The Manufacturing Process Has Changed

One reason that the price has changed is because of changing technologies and manufacturing processes. Synthetic human insulin debuted in the 1980s and genetically modified analog insulin was developed in the 1990s.

Analogs are more effective and predictable. They also take effect faster and are better at stabilizing blood sugar levels. Because they are so superior, 96% of US insulin prescriptions are for analog medications.

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How This Affects People With Diabetes

The rising cost of insulin makes it difficult for many people to afford it. According to the ADA survey, 27 percent of respondents said the high cost of insulin changed how much insulin they were able to buy or use.

For many respondents, these changes included using less insulin than their doctor prescribed by regularly skipping doses or rationing their supply.

Rationing insulin or skipping doses is very dangerous. It can lead to serious complications such as diabetic ketoacidosis. This complication, which can be fatal, is more common if you have type 1 diabetes and ration your insulin.

However, there are resources available to help you afford the insulin you need. Well be discussing several of those resources below.

Insulin manufacturers offer pharmaceutical assistance programs to help people afford their insulin. Each major manufacturer has its own program. Youll need to meet set income requirements to qualify for these programs.

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Us Analog Insulin Prices

In the US, drug prices are not static, but vary day-to-day, place-to-place and person-to-person. When someone goes to a pharmacy to purchase a drug that is medically prescribed, the out-of-pocket price they must pay for that drug can be influenced by a complicated web of contractual relationships, discounts, and rebates between numerous private intermediaries involved in the supply chain between the drug manufacturer and the patient.

We wrote letters to the three insulin manufacturers included within the scope of this report, requesting information on, among other things, point-of-sale out-of-pocket cost data for their products. Neither Sanofi nor Novo Nordisk provided data responding to this specific request. In its response, Eli Lilly wrote that:

Today, anyone is eligible to purchase a monthly prescription of Lilly insulin for $35, whether they use commercial insurance, Medicare Part D, Medicaid, or have no insurance at all. The average monthly out-of-pocket cost for a prescription of Lilly insulin has dropped 27 percent, to $28.05, over the past four years average monthly prescription of Humalog is 3.3 vials the average monthly out-of-pocket cost translates to $8.50 per vial.

How Not To Cut Costs

Insulin and prescription medicines cost much more than they did just 10 years ago. When medicine prices go up, people sometimes take less than they need to save money. But not taking medicine as prescribed can cause serious health problems and can end up costing you much more for treatment or even hospitalization as well as lowering your quality of life.

  • Dont stop taking medicines you need.
  • Dont skip doses.
  • Dont split pills that arent meant to be split.
  • Dont share items that enter your skin, such as fingerstick devices or insulin pens. You could get a serious infection.

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The United States Does Not Have Price Controls

However, one of the main reasons that insulin is so expensive in the United States is simply because we do not have any price controls. Only 7% of the worlds diabetics live in North America, and yet North America is responsible for 52% of global insulin revenue.

There is a raging debate in the United States about how health care should be paid for. Some favor universal health care others prefer our current system. Either way, we need cheap diabetic supplies and more reasonable insulin prices.

I, personally, agree with Dr. Ira B. Hirsch:

is not a concierge drug that should be used by only those who can afford it. Insulin, in my view, is a right, not a privilege. And although I have no problems with the newest and greatest insulins receiving whatever cost the market can bear, older insulins yes, including the insulin analogs ideally should be made available for all Americans at a reasonable cost.

This concept may seem counter-intuitive for many in the United States and perhaps would make us look more like our neighbors and our friends in Europe. But to those who detest the thought of having our government involved in the distribution of insulin, I would say that I detest more the pain, suffering, cost, and potential death from diabetic ketoacidosis resulting from patients inability to afford insulin. Insulin should be readily available to anyone who needs it.

Lilly Cares Foundation Patient Assistance Program


The Lilly Cares Foundation Patient Assistance Program provides free Eli Lilly insulin products for people with a limited income who have Medicare Part D or no insurance coverage.

The income requirements depend on your state and the specific Eli Lilly insulin your doctor has prescribed. Youll need to reapply for this program every year.

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How Much Does Insulin Cost Heres How 28 Brands And Generics Compare

Key takeaways:

  • GoodRx research shows that the average retail price for insulin rose 54% from 2014 to 2019.

  • As millions of Americans struggle to afford basic household needs during COVID-19, those prices have decreased only about 5% from January 2020 to October 2021.

  • While the Biden administration, manufacturers, states, and insurers have responded with efforts to curb insulin prices, FDA approvals of generics and biosimilars have largely driven the downward trend in overall cash prices.

There Is No Competition

Part of the reason that insulin is expensive is because there is a lack of competition. Three companies are responsible for 99% of the insulin market. In the United States, these companies are protected from generic competitors under patent law. The manufacturers continue to make tiny changes to their insulin products in order to extend their exclusivity rights. For example, Sanofi has filed 74 patent applications for Lantus alone.

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How To Get Diabetes Prescription Assistance From Simplefill

We take advantage of available pharmaceutical companies prescription assistance programs and apply on our patients behalf. We manage all the assorted paperwork, phone calls and red tape required so our patients can focus on living well. We examine each application individually and provide diabetes help for patients who qualify.

For long acting insulin, rapid acting insulin and diabetes medication help, read through our frequently asked questions and apply today for diabetes prescription assistance.

Corporate Human Rights Responsibilities

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Even in the absence of regulations, under the UN Guiding Principles on Business and Human Rights , all businesses have a responsibility to respect human rights and ensure that they do not cause or contribute to actual or potential adverse human rights impacts.

Fundamental to this responsibility is the requirement that companies carry out human rights due diligence to identify the possible and actual human rights impacts of their operations, and to establish meaningful processes to prevent and mitigate those risks and remedy adverse impacts. The process should be ongoing and continuous.

Companies should meaningfully consult with potentially affected groups and other relevant stakeholders at all stages of human rights due diligence. This consultation should be meaningful and go beyond engaging with a few patient representatives.

Human rights due diligence also entails identifying and rectifying business practices with adverse human rights impacts that are part of a companys operations. The UN Guiding Principles state that businesses should look at their own activities and embed human rights policies across all relevant business functions.

Pharmaceutical companies also have responsibilities as outlined in the 2008 Human Rights Guidelines for Pharmaceutical Companies in relation to Access to Medicines , issued by the UN Special Rapporteur on the Right to Health.

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Legislation And The Future Of Insulin Affordability

There are multiple efforts underway to reduce the cost of insulin. Lawmakers and advocacy groups alike are working to help people afford insulin.

The ADA has endorsed three possible pieces of legislation that could affect insulin affordability if they were passed. These are:

  • The Insulin Price Reduction Act. This act would provide incentives for manufacturers to lower the cost of insulin.
  • The Safe Step Act. This act would eliminate insurance company step therapy programs that can drive up costs.
  • The Chronic Condition Copay Elimination Act. This act would remove copays for medications used to treat conditions such as diabetes.

These acts may not pass and become law. However, theyre among the current suggestions to help bring down the cost of insulin. Broader healthcare laws and acts that aim to bring down the cost of accessing care in the United States could also affect the cost of insulin.

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