Why was my Insulin only $25 today?

So, I just picked up my first Rx for the year. First payment toward my deductible. Its Humalog from Lilly. I expected to pay $300. They charged me $25.

This has never happened to me before. All the pharmacist knew was that there was a “manufacturer coupon,” applied. No additional information. Its very exciting.

Do you think it is because my state is suing insulin manufactures for price gouging? They filed suit a couple months ago.

“The federal lawsuit named three companies in Sanofi-Aventis, Novo Nordisk and Eli Lilly that since 2002 have tripled the list prices of their synthetic insulin medications, which people with diabetes need to manage their blood sugar and reduce their risk of disability and death. But Swanson said their price hikes are due in part to the rebate structure created by pharmacy benefit managers (PBMs) who have ignored the rising costs and their impact on patients.”

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Pharmacies are getting better at automatically applying pharma discounts to your prescriptions. Lily will pick up the difference between what your insurance pays and the cost of the insulin so you only pay $25. Look at your Rx claims in a couple of days to see if you got credit for the full amount-that’s how I satisfied my deductible faster in 2017 without having to actually come out of pocket.

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Say what ? ! ? ! It might get applied to my deductible? Hallelujah!!! My finances are saved this month!!! https://www.leonardcohen.com/video/hallelujah

I thought maybe my pharmacist had a little crush on me and got me a killer coupon. He’s one of out best, bright young-thing pharmacists in town, I think. Does he get any credit? I’d really like to know who gets credit for this. :rofl:

Perhaps this is the right hand and the left hand of the insulin manufacturers. The right hand is greed and the left hand is fear? Are they responding to the suit?

I dont understand.

Coupons are good. Even Bill Gates famously used coupons when he was already a billionaire many times over.

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I think some of it is political pressure, but pharma does often make a discount program for new drugs that roll out to reduce the out of pocket purchase price for up to a year. A friend of mine is finishing up her final year of pharmacy

Pharma isn’t going broke any time soon, so look for discounts on all your name brand meds and don’t hesitate to use them.

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Better than discounts is getting something expensive thru a Patience Assistance Program. I get Dexilant and Lyrica that way–zero cost and delivered to my home.

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Agreed, if you qualify. I’ve received my fair share of meds over the years through assistance programs.

I always found RxAssist to be the best all in one resource. https://www.rxassist.org/patients

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Maybe you should give him an extra little smile next time…

:stuck_out_tongue:

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I not afraid to engage in a little friendly sexual harassment, but good pharmacists are hard to come by. Too risky.

I just calculated that at $325 per bottle of 100 units of Humalog, a snickers bar (28 grams) would cost me $13 in insulin to eat. That’s $3.25 per unit. 4 units for approximately 30 grams. Can that be? That doesn’t seem possible…

My calculations show that my savings today should fund my campaign at the capitol. However, if I hand out candy, then I stand to loose an incredible amount in insulin costs due to eating some of the candy.

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Did you say, “Too frisky?”
ha ha ha

BTW - A vial has 1000 units. So if the rest of your calculations are correct then your Snickers bar is only $1.30 (in terms of cost of insulin for the carbs). So your world is still safe. You can have a Snickers !!!

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hahahaha

Oh, I see. Its 100 units per ml.

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The most likely answer is your insurance formulary changed in your favor. Call them.

Insulin is in the top 5 most expensive liquids in the world

https://beyondtype1.org/the-10-most-expensive-liquids-in-the-world/

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mohe… or should it be mo**her**?..

That would be one very, very EXPENSIVE candy bar… Ya missed a digit/decimal point in thaR.

Still, adding say just 32.5 cents, depending, makes that Snickers a bit more expensive for us.

Man-0-man, am I lucky! Since I get, currently, knock on Woody, my insulins FREE, I can eat all the Mounds, 3muskateers apple pie, & even a Bavarian cream paczki I want without adding a single penny to my cost.

*** I now pause typing, for a bolus break***
(yes I really just ate a Bavarian Cream paczki) It is all YOUR FAULT! for mentioning treats with a paczki too close to resist.

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Had to google that: mmmmmmmm!

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image

You think the PBM has something to do with coupons issued by the manufacturer. They might issue coupons? I mean, I feel like I won some kinda fantastical reward, but also I feel like they just ripped me off of less money than they normally would.

Is this the PBM that is lording over me?

Why is this all so complicated? I’m gonna call the manufacturer and ask.

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I had a job supporting mainframe communications software back in the day. It was a job that reduced most who dared attempt it to tears in a day or so. And I’ll be damned if I can figure that chart out.

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I think I found it. But, be prepared for some reading…I will need to read this more than once, but I think I’m getting to the bottom of it (kinda).

Source #1: " Prescription Drug Coupons: A One-Size-Fits-All Policy Approach Doesn’t Fit The Evidence"
https://www.healthaffairs.org/do/10.1377/hblog20180215.988517/full/

"The widespread use of coupons by nearly all brand manufacturers can be seen as a response to growing control of formularies by a handful of pharmacy benefit managers. The three largest (Express Scripts, CVS Caremark, and OptumRx) control two-thirds or more of the United States market. A drug’s place on their national formularies directly affects market share. For example, a statin may be preferred on one formulary and not preferred on another, prompting the manufacturer who finds itself on a higher copay tier to issue coupons to stay competitive.

Such coupons may weaken the cost control design of the PBMs, but their impact on overall drug spending is uncertain. The PBM which extracts a $100 rebate from a manufacturer may or may not pass all the savings along to insurers, which may or may not pass them on to consumers in the form of lower premiums. But a $100 copay coupon bestows savings directly on the patient using the drug."

Source #2. " Prescription Drug Copayment Coupon Landscape"

So, maybe due to all their bad press (and, the insulin manufactures are getting a sh!t ton of bad press here), the manufactures have chosen to issue coupons, now, when we are all paying 80 - 100% of retail until we reach deductible. Thats my guess. I will call the manufacturer and ask…indirectly.

If you need some tunes while reading, I imagine this is what the PBMs listen to while they calculate. Its got some great art by Turner (my favorite). Turner lit everything on fire. https://www.youtube.com/watch?v=GXFSK0ogeg4