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Pharmacist: Patient education needed for caps on out-of-pocket insulin

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Posted at 1:59 PM, Jan 22, 2024
and last updated 2024-01-22 15:15:51-05

For those living with diabetes who rely on insulin, there are so many supplies that come with the disease. You have insulin, test strips, lancets, the testing device itself (glucometer), a pump if you use one, a continuous glucose monitor, and more depending on what medical equipment you use. It's a lot and the cost of caring for the disease easily adds up.

So, it comes as a relief that this year, pharmaceutical company Sanofi announced a $35 cap on out-of-pocket costs for patients who use Lantus – Sanofi's most prescribed insulin in the United States. Other drugmakers Eli Lilly and Novo Nordisk have similar insulin cost-savings programs (see all programs at the bottom of this article).

"I think that these steps are fantastic, but they're still steps," said Mindy Salango who lives with type 1 diabetes.

Salango knows first-hand what it's like to struggle with the cost of this disease. She says ten years ago, she went through a difficult time.

"I had insurance that was not great and the cost of my insulin and supplies was as much as my mortgage every month. And so, I had to ration insulin for a year."

Salango is in a much better place. Her current insurance keeps her prices at about $35 a month for insulin. While affordable insulin is the goal of these savings programs, she points out what she believes are some shortfalls.

"They're selecting which ones that they will offer at those prices."

"Not all insulins work the same for everyone."

"We still have a lot of boots on the ground and a lot of work to make sure that access to insulin is available to everyone."

She says in her advocacy work nationwide, she's learned some of the insulins are hard to find at pharmacies.

"You can have them already controlled on the medication and then all of a sudden it's not available," said Pharmacist Otis Kirksey, Director of Pharmacy Services for Neighborhood Medical Center in Tallahassee, Florida.

Kirksey has been advocating for affordable insulin for years, often helping uninsured diabetic patients navigate what he says can be an arduous process.

"We've resulted to doing things like patient assistance. But that's an application process that, there's a lag time, three or four weeks before the medication is available."

He thinks caps on out-of-pocket insulin costs are a step in the right direction. The education piece, he says, is also a necessary part.

"The issue is that each of the manufacturers have different criteria which is confusing for patients, it was confusing for me."

"I think the challenges that we're going to see is that the people who really need it, they don't have access to -- they don't know about it."

"We don't want anyone rationing insulin."

If you need help navigating financial resources for your diabetes care, The American Diabetes Association has a toll-free number you can call. It's 1-800-342-2383 and the hours of operation are Monday through Friday, 9:00 a.m. to 5:30 p.m. ET.

You can also check out the ADA's website to learn about ways to lower costs based on your situation.

E.W. Scripps reached out to media spokespeople for Sanofi, Eli Lilly, and Novo Nordisk for comment.

See the drugmakers' responses below.

Eli Lilly:

Lilly has a simple $35 co-pay program for all our insulins that is helping more than 100,0000 people save $20 million each month. It is so simple, in fact, that for most people with commercial insurance, there are no steps to take at all: we’ve automated the $35 cap wherever possible. That means when they go to the pharmacy, they get their monthly supply of Lilly insulin for $35 automatically, with no action needed by the person filling the prescription.



For those with no insurance or those who visit the minority of pharmacies without the technology to allow Lilly to automate the process, we have made it extremely easy to obtain the $35 savings card. People can visit https://www.insulinaffordability.com/ [insulinaffordability.com], check two boxes, and within seconds receive a savings card to fill their entire monthly prescription of any Lilly insulin for $35. 



Those without internet access, or who prefer to have someone guide them through the process, can get the $35 card by calling the Lilly Diabetes Solution Center at 1-833-808-1234. Either way, our $35 program does not require any application, waiting period, identifying information, or income thresholds. 



Our $35 program is making a real impact. Because of our efforts, people pay an average of $20.48 for a month’s supply of Lilly insulin – and that was before we announced significant steps [lilly.mediaroom.com] on March 1, 2023 that we expect will drive that number even lower. 

 Novo Nordisk:

    • A $35.00 insulin option called MyInsulinRxTM is available from Novo Nordisk Inc for eligible patients. The program builds on existing Novo Nordisk insulin affordability options and is intended to further lower out-of-pocket costs for eligible people living with type 1 and type 2 diabetes. 
    • We have offerings with national pharmacies that provide human insulin for about $25 per vial.
    • Novo Nordisk lowered the U.S. list prices of several insulin products by up to 75% for people living with type 1 and type 2 diabetes. Products include both pre-filled pens and vials of basal (long-acting), bolus (short-acting) and pre-mix insulins. Novo Nordisk also reduced the list price of unbranded biologics to be the same or a lower list price of each respective branded insulin. Read more here.
    • Approximately 63,000 patients in the US received free insulins from Novo Nordisk, and almost 1.4 million patients used some form of Novo Nordisk assistance when accessing our insulins. Novo Nordisk also has an Immediate Supply program in the US where eligible patients at risk of rationing can receive a one-time, free, short-term supply of insulin (up to three vials or two packs of pens).

Sanofi:

Sanofi has a suite of innovative and patient-centric savings programs to help people reduce the cost of their diabetes medicine (Admelog, Apidra, Lantus, Toujeo, and Insulin Glargine U-300) to a price of $35 or less for a 30-day supply, regardless of income or insurance status.


  • We continue to broadly share information about all our programs with all customers, stakeholders (including healthcare providers who prescribe our medications), and pharmacists. 

  • For Sanofi medicines:

  • In addition:

    • Sanofi joined Beyond Type 1 and many other manufacturers and advocacy organizations on the launch of GetInsulin.org [getinsulin.org] to ensure our innovative savings programs are included on their website that was created to help people living with diabetes connect to the program that best serves their unique situation.
    • Sanofi also has ongoing collaborations with Amazon Pharmacy [aboutamazon.com] and GoodRx [investors.goodrx.com] to expand access and affordability pathways to people who rely on our diabetes medications.