Report: These insulin price cuts aren’t really helping uninsured Americans

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An investigative report co-signed by three senators has found that uninsured Americans are still paying far too much for insulin lispro, even though the manufacturer has promised to lower the price.

Insulin lispro is essentially a generic version of Lilly’s Humalog, one of the country’s best-selling insulins, a fast-acting insulin typically used before meals or to quickly correct high blood sugar. Insulin lispro is chemically identical to Humalog and is manufactured by the same company but sold under a different name and at a lower price.

In early March, Lilly rocked the diabetes world when she announced she would cut insulin prices in the United States. It was widely seen as an unexpected and dramatic victory for the activists who have drawn attention to the insulin affordability crisis for years. Two other major insulin makers, Novo Nordisk and Sanofi, soon followed suit, announcing price cuts of their own (most of which are set to take effect in 2024).

As part of its sweeping price cuts, Lilly promised to lower the list price of insulin lispro to just $25 per vial. Theoretically, everyone without insurance would have to pay exactly this price. But the new report, prepared by the offices of U.S. Senators Elizabeth Warren (D-Mass.), Reverend Raphael Warnock (D-Ga.), and Richard Blumenthal (D-Conn.), found that uninsured Americans found far higher prices for insulin lispro.

The investigation (PDF) surveyed over 300 pharmacies and found that vials of insulin lispro had an average price of $97.51, almost four times the $25 that Lilly announced in press releases, media appearances and on Capitol Hill. In certain pharmacies, the drug cost up to $300 per vial.

Insulin lispro was also simply not available in much of the country. While 79 percent of the pharmacies surveyed stocked Humalog, only 43 percent had insulin lispro. Unfortunately, the nationwide pharmacies that most commonly stock insulin lispro — including Walmart, Walgreens, and Rite Aid — also charged some of the highest prices for the drug, often well over $150 per vial.

The report also describes how patients “need to untangle a confusing jungle of coupons, competing generics and misleading information” to get insulin lispro. Many patients are unaware that there is a cheaper generic alternative, and pharmacists typically don’t take the initiative to inform them or educate patients about Lilly’s affordability programs, which can be difficult to navigate.

In a letter (PDF) to Sen. Warren, the nonprofit advocacy group for insulin affordability T1International detailed similar results from his own investigation. Volunteer patient advocates across the country called pharmacies and found that the average price quoted was $107.31. The organization also found that many pharmacists were unaware that Humalog can be substituted for insulin lispro without a separate prescription, resulting in unnecessary extra work and red tape.

More than 20 states have now capped insulin co-payments, but almost none of these legislative efforts have addressed the plight of uninsured Americans, who often pay prohibitively high prices for insulin. Some proponents even have recommended that co-payment caps actually do more harm than good by “hiding the true price of insulin from privileged patients with private insurance,” thus weakening support for legislation that could meaningfully help those without insurance.

The senators ended their report by calling for federal policy changes specifically targeting the cost uninsured Americans with diabetes pay for their insulin. Although Americans of all political persuasions tend to Support limits for insulin pricesPrevious efforts at the federal level have tended to fail in Washington, DC.

in one press releaseWarnock said: “Manufacturers and insurers have taken steps to make insulin more affordable, but that’s not enough to ensure that nobody has to give up their rent or their groceries to afford the insulin they need to survive.”

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