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

Eli Lilly announced on March 1, 2023 that it will cut the list price of its most commonly prescribed insulins by 70% and immediately cap what many patients pay at the pharmacy counter at $35 or less per month ^[1]. It is the first move of its kind by a major US insulin manufacturer, and it comes as lawmakers and patient groups press drugmakers over prices that have more than tripled in the last two decades ^[2].

The changes roll out on different dates. Lilly is cutting the list price of its non-branded Insulin Lispro Injection 100 units/mL to $25 a vial effective May 1, 2023, which the company says will make it the lowest list-priced mealtime insulin available and cheaper than a Humalog vial cost in 1999 ^[1]. For comparison, a prescription for generic Humalog has been running between $44 and close to $100 on the website GoodRx ^[2].

The 70% list price cuts to Humalog (insulin lispro injection) 100 units/mL and Humulin (insulin human) injection 100 units/mL take effect in the fourth quarter of 2023, which starts in October ^[1][2]. Lilly did not say what the new prices will be ^[2]. Separately, on April 1, 2023, Lilly is launching Rezvoglar (insulin glargine-aglr), a basal insulin that is biosimilar to and interchangeable with Sanofi's Lantus, at $92 for a five-pack of KwikPens — a 78% discount to Lantus ^[1].

Because list price changes take time to move through insurance and pharmacy systems, Lilly said it would act immediately on out-of-pocket costs. Effective right away, the company will automatically cap out-of-pocket costs at $35 at participating retail pharmacies for people with commercial insurance who use Lilly insulin ^[1]. The Associated Press described the cap as applying at most retail pharmacies ^[2]. People without insurance can download a Lilly Insulin Value Program savings card at InsulinAffordability.com to get Lilly insulins for $35 per month ^[1]. Medicare's own $35 cap for its prescription drug program took effect in January 2023 ^[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," Lilly Chair and CEO David A. Ricks said ^[1]. He also noted that "7 out of 10 Americans don't use Lilly insulin" and called on other companies, policymakers and employers to act ^[1]. American Diabetes Association CEO Chuck Henderson applauded Lilly's steps and urged other insulin makers to cap patient costs as well ^[2]. Sanofi and Novo Nordisk did not immediately respond to the AP's request for comment ^[2].

Why it matters for patients

List prices matter most for people who are uninsured or who have high-deductible plans, since those are the patients sometimes stuck paying close to the sticker price ^[2]. More than 8 million Americans use insulin, according to the American Diabetes Association, and some face annual insulin costs of more than $1,000 ^[2].

The caps and price cuts apply only to Lilly insulin products named in the announcement — Humalog, Humulin, the non-branded insulin lispro, and Rezvoglar ^[1]. Nothing in these sources addresses pricing for GLP-1 medicines such as semaglutide or tirzepatide, so this announcement should not be read as changing what those drugs cost.

Analysts framed the move as both meaningful and manageable for Lilly. Vanderbilt health policy professor Stacie Dusetzina said the cuts "could actually provide some substantial" relief, but noted the insulins are older and some already face competition, which "makes it easier for Lilly to go ahead and make these changes" ^[2]. Humulin, Humalog and its authorized generic brought in more than $3 billion in revenue for Lilly last year, down from more than $3.5 billion the year before ^[2]. Larry Levitt of the Kaiser Family Foundation said drugmakers may be seeing "the writing on the wall that high prices can't persist forever" ^[2].

What happens next

April 1, 2023: Rezvoglar launches at $92 per five-pack of KwikPens ^[1]. May 1, 2023: non-branded Insulin Lispro drops to $25 a vial ^[1]. Fourth quarter 2023: Humalog and Humulin list prices fall 70% ^[1][2]. Lilly said it will also launch a nationwide awareness campaign in the coming weeks ^[1]. Whether Sanofi and Novo Nordisk follow is not yet known ^[2].