- Eli Lilly & Co. and pharmacy benefit manager Express Scripts have teamed up to offer discounts on some of the pharma company's insulin products to uninsured patients and those who are in the deductible phase of their high-deductible insurance plans.
- The discounted prices will start Jan. 1, 2017 and be available via web and mobile platforms provided by Blink Health.
- The program will cover Lilly's aging insulins Humalog and Humulin, as well as the Lantus follow-on biologic Basaglar which Lilly and Boehringer Ingelheim are launching in the U.S. this month.
Insulin drug pricing has increasingly become a hot-button issue, broadening the wider debate about drug prices which continues to simmer in the U.S.
Senator Bernie Sanders, I-VT, has been particularly vocal in his criticism of insulin drugmakers, calling out both Eli Lilly and Novo Nordisk on Twitter. The scrutiny has only added to tightening market pressures for the leading companies in the space.
Some insulin makers have failed to work well with pharmacy benefit managers (PBMs) and therefore have suffered, struggling to maintain market access and share.
Lilly, on the other hand, has worked closely with PBMs and appears to be reaping the benefits amid tightening market conditions. Earlier this year, CVS Health, another larger PBM, announced it would cover Basaglar on its national formulary, prioritizing what is expected to be a cheaper insulin product, instead of Sanofi's glargine products Lantus and Toujeo.
Lilly's willingness to work with PBMs has given it an advantage over competition like Novo Nordisk and Sanofi, both of which have cut staff in their diabetes units due to pricing pressures. Lilly is also reportedly trimming jobs, according to the Indianapolis Business Journal, but the decision appears tied to patent expiries for non-diabetes products.
"Changes in insurance benefit design have increased the cost of insulin for some people. While discounts and rebates paid by manufacturers make insulin affordable for most people, they don't directly help the uninsured or people in the deductible phase of their high-deductible plans," wrote Lilly in a statement, which expects the program to offer some patients a discount as high as 40%.
"And while some high-deductible plans exempt insulin from the deductible phase, others require people to pay most or all of the retail price until the deductible is met - meaning these people don't fully benefit from rebates when they visit the pharmacy."
One caveat — people using the discount program will have to outside their insurance to benefit from the savings, which likely means that spending would not count toward a health plan's annual deductible.
Earlier this year, Express Scripts added diabetes drugs to its SafeGuardRx program, using caps on per-patient spending to help curb costs.