At Lilly, we create medicines that make life better. But we don’t stop there. We also work every day alongside doctors, health insurers and pharmacies, so when anyone needs a Lilly medicine, they can get it – at a reasonable cost.
Unfortunately, in today’s U.S. health care system, this goal is more challenging to achieve. So Lilly is taking action on several fronts to create solutions that help bring consumer prices down.
Helping Patients Afford Insulin
For the first time, our Integrated Summary Report discloses the average list and net prices of a specific product – our Humalog insulin. Lilly receives $135 per month for each patient who takes the average prescribed amount of Humalog U-100, our most commonly prescribed version of Humalog.
But we know patients' specific out-of-pocket costs vary significantly depending on numerous factors, most notably the type and terms of their insurance coverage.
So earlier this month, Lilly announced a half-price version of our Humalog insulin, called Insulin Lispro. It’s an authorized generic – identical to Humalog but without the brand name. Its list price will be 50 percent less than Humalog’s – providing a more affordable option for certain Americans in high-deductible health insurance plans, the uninsured and seniors that hit the coverage gap in their Medicare Part D plans.
People with diabetes can learn about Insulin Lispro and other cost-saving programs through the Lilly Diabetes Solution Center, a helpline we launched last year for anyone facing high out-of-pocket costs. It can identify cost-effective solutions for people, based on their location, financial means and health coverage. More than 10,000 people each month are calling the center to get help with their insulin.
To help patients afford our medicines, we give billions in rebates and discounts to health insurers, pharmacy-benefit managers and other payers. After these rebates and discounts, the final amount Lilly receives was 46 percent of our list prices last year. That’s down from 70 percent in 2013.
Because of these growing rebates and discounts, the average U.S. net price of Lilly medicines—the final amount we receive from selling our products – declined 0.5% last year.
Getting Rebates to Patients
The problem is those rebates and discounts are reaching fewer people because more people are in health plans with high deductibles or co-insurance. They are often exposed to the full retail price – which no one is supposed to pay. So Lilly is working with payers to make sure the rebates pharmaceutical companies pay directly benefit patients.
Lilly changed its own health plan last year so that our employees and their families receive the rebates on medicines at the point of sale. This program, operated by CVS Caremark, helped more than 11,000 people save about $3 million last year. We think all health plans should do this.
Lilly’s health plan also excludes chronic medicines – like insulin – from our high-deductible health plan, relieving people with chronic disease of the financial burden of their medications. We’re part of a coalition calling on the federal government to clearly allow all employers to do the same.
Another important change, which we support, is the rebate reform recently proposed by the U.S. Department of Health & Human Services. It would allow rebates in public health plans only if they are shared with patients, cutting their costs.
The current drug pricing system is unsustainable. It’s time for change.
But we can’t solve this problem by ourselves. The entire health care community – payers, policymakers and pharmaceutical companies – must come together to create a better, more affordable system for patients.