Lilly to Introduce Lower-Priced Insulin


#1

BREAKING NEWS!

Lilly to Introduce Lower-Priced Insulin

Eli Lilly and Company today announced we will introduce a lower-priced version of Humalog® (insulin lispro injection 100 units/mL) in the United States – providing people with diabetes an insulin option that will have a list price 50 percent lower than the current Humalog list price.


#2

What a deal. So that means that Humalog will now only be 5 times the cost in the US that it costs to buy Humalog over the counter in Canada/China/India etc.


#3

This is a step in the right direction. The US insulin market is so far out of whack, it will take many more steps like this to align with a rational price. Lilly is one of the big three; I’ll be curious to see if Sanofi or Novo Nordisk respond.


#4

I thought Humalog has always been “Lispro”. You all know that, right?


#5

As you point out it’s a bit underwhelming, given the titanically inflated price point they’re starting from. I would guess the idea is to say “Hey, we dropped it 50%, what more do ya want!” while still maintaining a ludicrously inflated profit margin vs what it was when it was introduced back in the 90s. Basically a PR move to lower the heat on all the recent furor around insulin prices, people rationing, dying, etc.

Interestingly, I was googling around to buttress my understanding that the analogs were vastly cheaper when they first came on the market (they were), and came across a DiabetesMine article that points out that insulin price-fixing goes back a lot farther than I thought—1941 in fact, ten years before NPH was introduced. They cite reports that

a federal grand jury indicted a corporate trio – insulin manufacturer Eli Lilly in Indianapolis, distributor Sharp & Dohme in Philadelphia, and drug maker and distributor E.R. Squibb & Sons in New York – for conspiring to unlawfully “bring about arbitrary, uniform, and non-competitive prices for insulin and to prevent normal competition in the sale of the drug.” That was a federal charge of violating the Sherman Antitrust Act, the landmark legislation preventing anti-competitive business practices."*

In the section titled “Historic Claims of Insulin Price-Gouging” we have “Mr Eli Lilly himself” quoted at the time saying:

“Our price is now 3.5% of what it was when it was first sold in 1923, and today it costs the average diabetic just 7.5 cents per day.”

So, yeah.

Still, it’s a crack in the facade. I’m not an economist, but my understanding is that a price-fixing regime, which is pretty much what we’ve been witnessing, requires all parties to remain unified—that’s kind of the point of it. If one of them breaks ranks, the whole thing falls apart. If that was in the offing, well, couldn’t happen to a nicer bunch of overpaid executives.

*In the end, the companies pleaded “nolo” and had to pay some paltry 4-figure fines.


#6

Thanks @Mila for this information! Hopefully all of the producers will follow suit.

I read the article, but I didn’t find anything that said how it works in relation to Humalog.

I have to wonder what is different about it, besides the name and the cost.


#7

Probably the color of the printing on the package


#8

So, just out of curiosity I plugged those numbers into an inflation calculator (average prices have increased 1,612.33% since 1941), and it appears that Lilly was charging the equivalent of $462.33 per year for insulin for an “average diabetic.” That comes out to a bit under $40 a month, presumably list price.

So, just for comparison’s sake, Lilly was being sued (successfully) for anti-competitive practices for charging patients unreasonable prices in 1941 that today would be considered incredibly cheap for almost any medication (before insurance). How times and standards have changed…


#9

These two words tell a big part of the story… and since nobody outside of cororate boardrooms actually know what the true net price is… I assume the margin you outline above is not terribly far off from reality…


#10

This insulin is 100% Humlaog. As explained today, the same liquid fills both vessels. It is a label difference, no other.


#11

Sanofi Aventis (Lantus and Apidra) already introduced a new copay card that is $99 for a vial of insulin and $149 for a box of pens for cash paying patients.


#12

Thanks, @Rphil2!


#13

Yeah, this makes it feel really, really dishonest to me. If they can re-label and sell the same medication for half the price and still make a profit, then they obviously have been engaging in systematic price gouging for years a this point (not that we didn’t know that already). What makes me really mad, however, is that they aren’t selling the “generic” version for a tenth of the mainline list price. That might be more realistically priced as a generic. This just makes the whole thing feel like a publicity stunt to try to deflect well-deserved criticism and anger from the public. Lilly wants to avoid being the next Martin Shkreli.


#14

Never mind the fact that they’ve relabeled and are going to sell for half the price AND continue selling the original at the original price… really all boils down to list price vs real price. By all available reports (granted, very few) the net price of insulin has actually decreased in recent years… Although actual consumers certainly aren’t in on that benefit though


#15

I accidentally came in on the tail end of the congressional hearing on drug pricing last week. What I heard was a lot of gibberish about how the list price is determined from the CEO’s representing several pharmaceutical companies. I had no idea what anyone was saying and thought it was because I had missed the beginning of the hearing. OR, . . . maybe I don’t have a clue as to how it works in the drug business. It sure isn’t like any other pricing I have ever heard of in my little world.

I did not understand a lot of the industry jargon used. It was a bit like listening to a foreign language. I know every industry has its own terminology of which outsiders have no clue but this was way beyond anything I could decipher.

Maybe someone here watched the hearing and can shed some light on it for us.

Post Script: Came in means flipping to C-Span on TV (not in person at the hearing) One of my senators was on the committee and I did not understand him, either. Maybe I should write him for an explanation.

Maybe I should ask for a refund on my college degree from decades ago since I seem to be at a loss for comprehension.


#16

Anyone that goes before congress basically does the same thing–they spout nonsense. Look at Zuckerberg’s non-answers as a prime example. Hearings are nearly always a waste of taxpayer money and congress’s time that could be better spent cleaning up the rest of the tax code and other pressing business.


#17

And Admelog which is also Humalog in a different bottle.


#18

This whole thing is disingenuous.

Eli Lily and all the other pharma companies that produce insulin could have charged less all along.

This is the convoluted nature of PRICING in the American healthcare system. Nobody knows what the actual COST of a visit, procedure, test, or drug is. What we pay is determined by a complicated set of business arrangements between health care systems/big pharma and insurance companies/benefits managers.


#19

Lol, yep. It should be a few hundred % cheaper.


#20

Beyond Type 1’s coverage:

On Monday, March 4, Lilly Diabetes announced in a press release that an authorized generic version of Humalog insulin will be available in United States pharmacies for half the list price of Humalog.

Called Insulin Lispro, the generic version will be identical to rapid-acting Humalog, mirroring both its structure and function. The list price of one vial will be $137.35 and the price of a box of five pens will be $265.20. According to Lilly’s announcement, these products have already been manufactured and they plan to make them available in pharmacies around the United States quickly. Insulin Lispro will be sold under ImClone Systems, a Lilly subsidiary.

Insulin Lispro will be available to patients who take Humalog without an additional prescription from a doctor. Patients will be able to speak directly with a pharmacist to determine whether Humalog or Insulin Lispro is a more cost effective option for them.

So why not just cut the price of Humalog in half? High (and rising) list prices for Humalog are partially due to rebates paid by the insulin manufacturer to insurance companies and pharmacy benefit managers. These rebates guarantee Humalog is covered by insurance plans and available on formularies. Cutting the list price of Humalog would jeopardize insurance coverage for those currently taking the drug, but 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. The addition of Insulin Lispro to a formulary does not fundamentally change the system, but offers an additional lower cost option for people paying for insulin out of pocket immediately and within the confines of the current U.S. insulin pricing machine.

Lilly Diabetes confirmed today that their team is working with insurers, pharmacy benefit managers, and drug wholesalers to get Insulin Lispro added to formularies and covered by insurance alongside Humalog.

People without insurance who are paying 100% out of pocket for their supplies are likely to benefit the most from the half-price option. People with diabetes on high-deductible health insurance plans will also now have an 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 experience a change.

Enrique A. Conterno, the president of Lilly’s diabetes division, told the New York Times Friday that the list price for the new Insulin Lispro is set comparable to the net price paid by insurers in exchange for placement on their formulary. This represents a new move to attempt to better pass the savings offered to insurers and pharmacy benefit managers through to patients. In January, a new rule was proposed by Health and Human Services designed to encourage manufacturers to pass discounts directly to patients at the pharmacy by setting up a fixed-fee system between manufacturers and pharmacy benefit managers. The rule applies only to Medicare and its merits are being debated – but the proposal represents a future vision for drug pricing reform. According to Lilly CEO David Ricks, “for people with diabetes, a lower-priced insulin can serve as a bridge that addresses gaps in the system until a more sustainable model is achieved.”

The launch of a new insulin with a 50% lower list price comes in response to mounting pressure from insulin access advocates and recent political inquiries on the issue. Advocates have long argued that current discounts offered through insulin manufacturers do not adequately address the needs of people with diabetes struggling to afford life-sustaining medication. This announcement is likely to be seen as not going far enough in reducing the the list price of insulin.

David Ricks said in an interview with the New York Times, “there are clearly patients who, despite many best efforts, are struggling to afford their insulin…This is a step we can take to close part of that remaining gap.”

Today’s announcement follows the mid-2018 launch of the Lilly Diabetes Solution Center, a hotline offering personalized help for individuals to understand their assistance options. While Novo Nordisk and Sanofi both offer patient assistance programs as well, the two other major insulin manufacturers have not introduced new solutions to recent pricing pressures.

Lilly isn’t the first drug company to launch a generic version of its brand-name product to address pricing pressure. In 2016, advocacy around the price of EpiPen spurred Mylan to begin selling an authorized generic. And while several generic and biosimilar insulins do exist, insulin currently lacks a generic market that offers substantially lower list prices. When Sanofi’s Admelog reached market in 2018, it cost $233 per vial and $450 per box (list price), offering only a 15% price discount from Humalog. Basaglar’s launch saw similar price savings. The 50% discounted list price for Insulin Lispro represents the first substantial reduction in list price.

“While further action, across the healthcare system, must be taken to ensure unqualified access to affordable insulin, today’s announcement of a 50% lower list price generic is an important step in the right direction,” said Beyond Type 1 CEO Thom Scher. “Lilly is presenting a meaningful change for the growing number of people paying out-of-pocket for insulin at the pharmacy, building on their other efforts in recent months. We are hopeful that other manufacturers and entities within the supply chain will take material actions as well.”

Read Beyond Type 1’s recent news coverage of the letter sent to insulin manufacturers by US Senators. If you or someone you know is struggling to afford insulin, know your options.