WRITTEN BY: Todd Boudreaux
On Friday, September 6, Novo Nordisk announced in a press release that authorized generic versions of NovoLog and NovoLog Mix will be made available on January 2, 2020. The news was part of a broader announcement of more affordable options coming at the start of the year. In addition to the authorized generics, Novo Nordisk will be offering a $99.00 Cash Card program for analog insulin.
The list prices for Insulin Aspart and Insulin Aspart Mix (generics for NovoLog and NovoLog Mix) are set at 50% of the list prices of branded versions. Prices for new authorized generics in vials and pens are listed below:
- Insulin Aspart 10mL vial/1000 Units: $144.68
- Insulin Aspart 5x3mL Penfill (box of 5 pens)/1500 Units: $268.73
- Insulin Aspart 5x3mL FlexPen (box of 5 pens)/1500 Units: $279.41
- Insulin Aspart 70/30 FOB 10mL vial/1000 Units: $150.06
- Insulin Aspart 70/30 FOB 5x3mL FlexPen (box of 5 pens)/1500 Units: $279.41
Novo Nordisk expects that Insulin Aspart will be available to patients who take NovoLog without an additional prescription from a doctor. Patients will be able to speak directly with a pharmacist to determine whether NovoLog or Insulin Aspart is a more cost effective option for them.The authorized generics will be made available from newly established Novo Nordisk US affiliate Novo Nordisk Pharma Inc. (NNPI).
The announcement mirrors that of Lilly Diabetes last March, when the company announced that an authorized generic version of Humalog — Insulin Lispro — was being made available for half the price of Humalog. The same question that Lilly Diabetes faced at the time is likely to be asked of Novo Nordisk: Why not just cut the price of NovoLog in half?
If Novo Nordisk were to cut the list prices of of its current insulins, it would jeopardize insurance coverage for them due to the complex system of insulin pricing in the United States. High (and rising) list prices for NovoLog and other insulins are partially due to rebates paid by the insulin manufacturer to insurance companies and pharmacy benefit managers. Introducing a generic insulin at half the cost means that insurers, pharmacy benefit managers, and other members of the supply chain will continue to receive large rebates through existing contracts on the brand name drugs, while Novo Nordisk can simultaneously offer a lower-cost generic option for those in need.
Novo Nordisk has indicated to Beyond Type 2 that they are in ongoing discussions with wholesalers and pharmacy benefit managers to encourage formulary uptake of the authorized generics.
People without insurance who are paying 100% out of pocket for their supplies are likely to benefit the most from the half-price options. People with diabetes on high-deductible health insurance plans (HDHPs) will also have another option that reduces monthly out-of-pocket expenses before they’ve met their deductible. Those with comprehensive drug coverage as part of insurance may not find this option helpful.
“People with diabetes need more affordable options and we are going to continue doing what we can now while also working with other healthcare stakeholders on longer-term system reform. For instance, we support the recent IRS ruling that classifies diabetes medications as preventive care. We believe this has the potential to help a significant number of people with diabetes from an affordability perspective,” said Doug Langa, Executive Vice President, North America Operations and President of Novo Nordisk Inc.
The IRS designation of insulin as a preventative service allows such medications to be exempt from the deductible phase of some health plans, preventing patients from ever paying full list price for their insulin. This guidance can be applied to health plans starting in 2020, and many are hopeful that insurance providers will opt in, as there is ample evidence to suggest that widening access for insulin will be cheaper for payers in the long term. Indeed, insurance providers as well as advocacy groups had been pushing for the change; managing chronic health conditions before they become exacerbated — and more costly — can be viewed as a win-win for both patient and insurer. For people with diabetes, uninterrupted access to insulin is both life-sustaining and cost saving.
The other new offer announced by Novo Nordisk launching on January 2, 2020 is a $99.00 Cash Card program for analog insulins which, according to the press release, “allows people with diabetes to purchase up to three vials or two packs of FlexPen/FlexTouch pens of any combination of Novo Nordisk analog insulins (3000 – 3600 Units total depending on brands) for a flat cost of $99.00.” The Cash Card program will be available to people with commercial insurance as well as the uninsured.
The press release also pointed to affordability programs currently offered by Novo Nordisk, as well human insulin from the manufacturer which is available for $25/vial at Walmart and other locations.