Even though insulin has been around for nearly a century, there is no generic form of the vital diabetes medication. In recent years, the price of insulin has risen sharply, leaving healthcare providers with concerns about patients who can’t afford insulin skipping doses and risking lost limbs and eyesight. Pharma giant Eli Lilly — maker of popular insulin brands Humalog, Humulin, and Basaglar — is now proposing a solution that it believes could make the medication more affordable — but only for some people.
The Wall Street Journal explains that the makers of the most popular name-brand insulins, which include Lilly, Novo Nordisk, and Sanofi, aren’t necessarily rolling around in piles of cash because of recent price hikes. Instead, the rise of pharmacy benefit managers are to blame, since the companies negotiate rebates based on high list prices, and those rebates aren’t available to the ordinary drug-buying public.
What they do mean is that patients who are paying cash because they’re uninsured, or in the pre-deductible part of a high-deductible insurance plan will be able to buy Lilly insulin products for about 40% off the retail price by ordering through this program.
Customers will order through the startup Blink Health, a company that lets patients order mostly generic medications online but pick them up at a neighborhood pharmacy. Express Scripts administers the program.
There are two important catches: first, people whose prescriptions are “reimbursed by any government program” aren’t eligible, which rules out users of Medicaid and Medicare, as many drugmaker discount programs do.
The second catch is that since buying through the discounted store means that purchases don’t go through a customer’s insurer, insulin purchases won’t count toward a patient’s deductible. Every patient will have to do the math to decide whether this program actually benefits them.