The End of Diabetes: The Eat to Live Plan to Prevent and Reverse Diabetes

The drugmaker Eli Lilly rocked the diabetes world last week when it announced that it would slash insulin prices in the United States. It’s been seen as an unexpected and dramatic victory both for the activists that have spent years bringing attention to the insulin affordability crisis, and for us regular folks that simply need insulin to live.

But what will it mean for you, and the price you pay every month for your insulin? This article will try to  explain.

Which Insulins Does Lilly Produce?

Eli Lilly is a pharmaceutical giant, but it only produces a minority of the insulin used in the United States. The drugmaker makes the following insulins:

• Basalgar (a basal or long-acting insulin)
• Humalog (a quick or meal-time insulin)
• Humulin N (an older basal insulin formulation)
• Humulin R (an older rapid insulin formulation)
• Insulin Lispro (a less expensive version of Humalog)
• Lyumjev (a newer ultra-rapid insulin)

Lilly will also bring a new insulin to market in April, 2023:

• Rezvoglar (a less expensive equivalent to Basalgar)

Which Insulins Are Receiving price Cuts?

Humalog:

Humalog, a rapid insulin for use before meals and for blood sugar corrections, is Lilly’s most popular insulin.

As of this writing, a pack of 5 3mL Humalog pens (1,500 units) is at present listed for 0.40. A single vial of Humalog (1,000 units) is listed for 4.40.

In late 2023, Humalog’s list prices will drop by 70 percent.

The cost reduction will cover many different forms of Humalog, including:

• Humalog U-100 (10mL and 3mL vials, cartridges, and KwikPen and Junior KwikPen)
• Humalog Mix 50/50 (10mL vial and KwikPen)
• Humalog Mix 75/25 (10mL vial and KwikPen)

The cost cuts do not apply to the Humalog Tempo Pen, part of Lilly’s smart insulin pen system.

Humulin N and Humulin R:

Humulin N and Humulin R are older insulin formulations. They are already quite a bit less expensive than the best insulins available today, but they are also considerably more challenging to use. These insulins are famously available for extremely low prices at Walmart without a prescription.

Lilly reports that Humulin insulin list prices will drop by 70 percent in late 2023, which may help diminish costs for anyone using these insulins, especially if they’re not already picking up their medications at Walmart.

Here are the exact formulations receiving cost cuts:

• Humulin N U-100 (10mL and 3mL vials, and KwikPen)
• Humulin R U-100 (10mL and 3mL vials)
• Humulin 70/30 (10mL and 3mL vials, and KwikPen)

Insulin lispro

Insulin lispro is a “non-branded” version of Humalog. Though it is essentially identical to Humalog, it is already listed at much lower prices:

• A pack of five 3mL Insulin Lispro pens is currently listed for 9.12
• A single vial of Insulin Lispro (1,000 units) is listed for .41

Effective May 1, 2023, Insulin Lispro’s list price drop even lower, to for one vial. It was unclear from Lilly’s press release if the price of Insulin Lispro pens will also drop.

Rezvoglar

Rezvoglar is not receiving a price cut, because it’s a brand-new product. But it will launch with a low list price.

This new biosimilar insulin is essentially a generic version of Lantus, and ought to be functionally equivalent to Basalgar. Rezvoglar will debut with a list price of for a pack of five 3mL pens (1,500 units). Lilly reports that this is 78 percent less than the list price of Lantus, which is currently retailing for about 0. Basalgar is currently listed at 6 for a five-pack of pens.

In November 2022, Rezvoglar was approved by the FDA for an “interchangeability” designation, which will make it much easier for pharmacies to swap Rezvoglar for Lantus.

Are Total Monthly Out-of-Pocket Capped at per Month?

Maybe. Some users may enjoy even more significant savings if their prescription costs are capped at per month. Here’s what Lilly says:

Effective immediately, Lilly will automatically cap out-of-pocket costs at  at participating retail pharmacies for men and women with commercial insurance using Lilly insulin.

A footnote vaguely explains that “participating retail pharmacies” include “the majority of retail pharmacies.” To find out if your costs will be capped, you will probably have to show up at the pharmacy and see what happens.

If your costs have not been capped, Lilly’s Insulin Value Program offers a saving card that can be downloaded instantly. This should cap your expenditure at per prescription per month.

What If I Don’t Have Health Insurance?

Most people in America with diabetes do not pay anything near the full list price for the insulin they use. A March 2022 analysis by Peterson-KFF suggested that about 75 percent of people with private or employer insurance already pay less than per month for their insulin. Americans without health insurance, however, can get stuck with jaw-dropping bills, prices that are dangerous and occasionally even deadly for patients without the means to pay them. Most government efforts to address the insulin affordability crisis — both failed federal legislation and successful state-level measures — doesn’t address this problem at all.

If you don’t have insurance, lower list prices should certainly help reduce your out-of-pocket costs.

As part of the new effort, Lilly has also streamlined access to its insulin affordability program. People without insurance can immediately download a savings card that limits out-of-pocket costs. The details are a little bit sketchy, and it’s unclear which insulins are eligible for the discount program. The fine print states that savings card users “may pay as little as per prescription per month for a 30-day supply of your Covered Insulin.”

What if I’m on Medicare?

Lilly’s announcement does not affect people with diabetes on Medicare.

Medicare recipients already have their out-of-pocket costs capped at per month, thanks to the Inflation Reduction Act of 2022.

What if I’m on Medicaid?

Lilly’s announcement does not affect people with diabetes on Medicaid.

Medicaid users are already substantially protected from potentially high cost insulin. A 2022 US government report to Congress found that the average insulin user on Medicaid spent per year on their insulin, far less than the 6 annually spent by those with private insurance, or the 6 spend by those without insurance.

The Bottom Line

If you use Lilly insulins, it’s difficult to predict how much less you will pay at the pharmacy. For many Americans, the slashed list prices may have relatively little effect. Some have even accused the business of “greenwashing.”

We encourage any readers that are struggling to pay for their insulin to take full advantage of the Lilly Insulin Value Program savings cards.

If you’re not a Lilly insulin user, the other major insulin manufacturers also have affordability programs which could substantially reduce your out-of-pocket costs. It may also be worthwhile to ask your doctor about switching to the un-branded Insulin Lispro rapid insulin, and/or the new lower-cost basal insulin Rezvoglar.

Diabetes Daily

The End of Diabetes: The Eat to Live Plan to Prevent and Reverse Diabetes