Lilly cuts Humalog and Humulin list prices by 70% and caps patient costs at $35 a month

Eli Lilly and Company announced on March 1, 2023 that it will cut the list price of its most frequently prescribed insulins by 70% and immediately limit out-of-pocket spending for many patients to $35 a month ^[1][2]. The changes cover two brand-name products, a lower-cost version of one of them, and a new biosimilar ^[1].

Humalog (insulin lispro injection) and Humulin (insulin human) injection, both 100 units per milliliter, will get 70% list price reductions in the fourth quarter of 2023, which starts in October ^[1][2]. Lilly did not specify the new dollar amounts ^[2]. A list price is the figure a manufacturer sets at the outset, and it is what people who lack insurance or have not met a deductible are sometimes billed ^[2].

Non-branded Insulin Lispro Injection 100 units/mL moves to a $25-a-vial list price on May 1, 2023 ^[1]. Lilly says that will make it the cheapest list-priced mealtime insulin on the market, below the price of a Humalog vial in 1999 ^[1]. NPR identified the product as an authorized generic of Humalog and reported that GoodRx listed prescriptions for generic Humalog at $44 to nearly $100 ^[2].

A third product, Rezvoglar (insulin glargine-aglr), reaches the market April 1, 2023 at $92 for a five-pack of KwikPens ^[1]. Lilly describes it as a biosimilar that is interchangeable with Lantus and priced 78% below it ^[1].

The $35 monthly maximum for people with commercial insurance took effect immediately at participating retail pharmacies, ahead of the list price changes ^[1][2]. Patients without insurance can get the same $35 monthly price for Lilly insulins by downloading a savings card from InsulinAffordability.com ^[1][2]. Medicare Part D has had its own $35 monthly limit since January 2023 ^[2].

Chief executive David Ricks said the price cuts will take time for the insurance and pharmacy system to put in place, which is why the out-of-pocket limit was applied right away ^[1][2]. "While the current healthcare system provides access to insulin for most people with diabetes, it still does not provide affordable insulin for everyone and that needs to change," he said ^[1]. Ricks also noted that 7 out of 10 Americans do not use Lilly insulin and called on policymakers and employers to act ^[1].

Humulin, Humalog and the authorized generic together brought Lilly more than $3 billion in 2022, after more than $3.5 billion the year before ^[2]. Stacie Dusetzina, a Vanderbilt University health policy professor who studies drug costs, told the Associated Press the changes could deliver meaningful relief and are unlikely to cost Lilly much, since the products are older and some already face competition ^[2]. American Diabetes Association chief executive Chuck Henderson welcomed the move and asked other manufacturers to cap patient costs as well ^[2]. Sanofi and Novo Nordisk did not respond immediately to the AP's request for comment ^[2]. Larry Levitt of the Kaiser Family Foundation said Lilly appears to be trying to get ahead of the issue and look good to the public ^[2].

More than 8 million Americans take insulin, according to the American Diabetes Association, and research shows insulin prices more than tripled over two decades ^[2]. President Biden called for a $35 cap for everyone in his State of the Union address in February 2023 ^[2]. California has said it plans to explore making its own cheaper insulin, and the nonprofit Civica intends to produce three insulins at no more than $30 a vial, a spokeswoman said ^[2]. Lilly said its average out-of-pocket cost for insulin has fallen to $21.80 over the past five years ^[1].

Why it matters for patients

The announcement separates two prices that are often confused. Insurance-linked caps, such as the $35 ceiling, govern what a patient pays at the pharmacy counter. List price cuts change the underlying benchmark that uninsured patients and people with high deductibles can be charged ^[1][2]. Patient advocates have argued for years that caps tied to insurance leave uninsured people out, which is why the list price reductions drew attention ^[2].

The $35 cap covers commercial insurance; Medicare Part D runs under its own separate limit ^[1][2]. Which pharmacies count as participating has not been disclosed ^[1]. Because the effective dates are staggered, patients may notice changes at different times, and what any one person pays still depends on their plan ^[1][2].

What happens next

April 1, 2023: Rezvoglar becomes available at $92 per five-pack of KwikPens ^[1].

May 1, 2023: the list price of Insulin Lispro Injection drops to $25 a vial ^[1].

Fourth quarter of 2023: the 70% list price cuts for Humalog and Humulin take effect ^[1][2].

Lilly said a nationwide public awareness campaign about its affordability programs will launch in the coming weeks ^[1].