Today’s guest blog comes from Mike Mason, Lilly's senior vice president of Connected Care and Insulins
Drug pricing – including for insulin – is top-of-mind for many people. It’s important to us, too. With the recent launch of Insulin Lispro Injection, the lower-priced version of our most commonly used insulin, Humalog U-100, Lilly has taken another step to help people facing high out-of-pocket costs. It’s the same medicine as our most commonly used insulin but with a 50 percent lower list price.
Insulin affordability is an example of why our health care system doesn’t always work. While 95 percent of people pay less than $95 per month for our most commonly prescribed insulin – and 43 percent pay $0 at the retail pharmacy – others struggle to afford the out-of-pocket costs required by their insurance plan.
Why is this?
We pay significant rebates so people will have low out-of-pocket costs on their insurance plans. Many employers prioritize using these rebates to keep premiums lower for their members rather than providing low out-of-pocket costs for insulin. As long as lower premiums are prioritized over affordable out-of-pocket costs for chronic medicines, the problem won’t go away.
However, analyses by Milliman have shown that for high deductible health plans, exempting insulin from all patient cost sharing would reduce the average insulin users’ total annual out-of-pocket costs by $481, while increasing premiums for all members by 43 cents per member per month ($5.12 per year).
To counter market incentives in the health care system today, change in our current healthcare system is needed.
But as I mentioned in my recent testimony before Congress, no one entity can do this alone. It will require partnership among all stakeholders across the health care system. Lilly is committed to continuing our work with health plans, wholesalers, employers, and the government to find permanent solutions that will help people afford their medicines.
These solutions include new public policies that will drive sustained improvements in affordability and access for everyone using insulin. In addition to supporting exemptions from deductibles for insulin and other chronic medicines, we support rebate reform as proposed by the U.S. Department of Health and Human Services to allow rebates in public health plans only if they are shared with patients to cut their costs. Lilly also supports legislation that would cap out-of-pocket costs for people using Medicare Part D – which would provide a critical financial safeguard for patients, leading to better treatment adherence and improvements in overall health status.
Lilly will continue to innovate and invest in ways that provide critical medicines to people who need them. While we work together to identify more sustainable solutions, Insulin Lispro Injection is a bridge that addresses gaps in the current system.