Stories about individuals struggling to afford insulin continue to make headlines. We and our partners in the diabetes community are committed to maintaining access to lifesaving treatments. As a united force, we are sharing resources to help those affected.
Eli Lilly—Solution Center helpline: 1-833-808-1234
Rising costs have made access to affordable insulin far more difficult for people with diabetes, especially low- income individuals, those on high deductible health plans, Medicare beneficiaries in the Part D donut hole, or those who are uninsured. Addressing insulin affordability is critical in ensuring that patients can effectively manage their diabetes and avoid unnecessary complications and hospitalizations. For many patients with diabetes, insulin is a life-saving medication. Policymakers should address drivers of rising insulin prices and implement solutions that would reduce high out-of-pocket expenditures for patients.
The Endocrine Society believes the following policy and practice changes could help expand access to lower cost insulin.
Greater transparency is needed across the supply chain to understand rising insulin costs
Future list price increases should be limited and reasonable financial incentives should be pursued by all stakeholders.
To reduce out-of-pocket expenditures, cost-sharing should be limited to a co-pay. In addition, NPH and regular insulin should be available at no cost to the patient.
Rebates should be passed along to consumers without increasing premiums or deductibles.
Patient Assistance Programs should less restrictive and expanded to include more accessible and easier to complete applications that can be used for multiple programs (e.g. a common application).
Health care providers should be trained to use lower-cost human insulins (e.g., NPH and regular), so they can prescribe as appropriate.
When clinically equivalent options are available, physicians should consider prescribing the lowest cost insulin.
The Federal government should address regulatory barriers to create a more favorable environment for the testing of incentive programs that reduce cost and improve care (e.g. value-based purchasing agreements).
Electronic medical records should include up-to-date formulary and price information.
Co-pay savings cards should be eliminated as they have been shown to incentivize the use of higher cost medications and raise the overall cost of drugs.
Patients should be educated about low-income assistance programs (e.g. the Extra Help program under Medicare) and to ask their physicians about alternatives if they cannot afford their insulin.
Gag rules, which prevent pharmacists from helping patients find less expensive ways to pay for their medications, should be eliminated.