Miriam E. Tucker
March 4, 2019
Eli Lilly and Company has announced the launch of a lower-priced version of its lispro (Humalog) insulin in the United States.
The new version is an "authorized generic" called Insulin Lispro. It will consist of the same molecule as Humalog and will be manufactured through a Lilly subsidiary, ImClone Systems. The list price will be $137.35 per vial and $265.20 per five-pack of KwikPens, roughly half the price of the branded versions, although insured patients will not pay that price.
Insured patients can access Humalog as they have been. The new lower-priced version will be an alternative for patients paying out of pocket, including those who are uninsured, who have high deductibles, or who are in the Medicare Part D coverage gap ("donut hole"). The new product "allows Lilly to provide a lower-priced insulin more quickly while providing payers time to renegotiate downstream contracts and adjust to new system economics," according to a company statement.
Vials and pens of Insulin Lispro have been manufactured, and Lilly is working with supply chain partners to bring the products to pharmacies.
Since 2015, Lilly has also manufactured Basaglar, a lower-cost biosimilar of insulin glargine (Lantus, Sanofi).
Insulin Manufacturers Under Pressure
Because insulin costs are preventing access for many patients, the three big insulin manufacturers — Lilly, Novo Nordisk, and Sanofi — have been pressured to account for why the price of the lifesaving medication has escalated so rapidly.
In late February, US senators Chuck Grassley, the Republican chair of the Senate Finance Committee, and Ron Wyden, the committee's top Democrat, sent letters to the heads of the three companies requesting that information.
With Humalog, the price increase was from $35 per vial in 2001 to $234 in 2015, the senators noted.
In response, the companies are emphasizing efforts they've taken to alleviate the price problem. Lilly's announcement of the new product included a reminder of its other initiative to lower insulin costs, the Lilly Diabetes Solution Center, which offers access to alternatives, such as donated insulin.
In an email regarding Lilly's announcement, Novo Nordisk spokesman Ken Inchausti told Medscape Medical News, "Bringing affordable insulin to the market requires ideas from all stakeholders, and we're aware that Lilly has taken a step to offer a lower-priced analogue insulin."
Inchausti pointed out that Novo Nordisk's human insulin (Novolin R, Novolin N, and fixed-dose combinations of those) is available for $25 a vial at chain pharmacies. The company also offers copay cards and a patient assistance program for those in need. "We will be watching this important development. We know that it requires a coordinated effort across all parties in the US health care system to solve affordability and access challenges in a sustainable way," Inchausti said.
Sanofi spokesperson Nicholas Kressman said in a statement to Medscape Medical News, "Sanofi supports any actions that increase access to insulins for patients living with diabetes, and there are different ways to accomplish this goal."
Sanofi, which manufactures the lower-cost lispro biosimilar Admelog, offers a savings program available at all US pharmacies that provides all of its insulins at approximately 50% off the list price — $99 for a 10-mL vial, or $149 for a box of pens — for uninsured or commercially insured patients. This offer is valid for ten 10-mL vials or ten packs of five pens per prescription. Eligible patients will pay $99 for one 10-mL vial of Admelog or $149 for one pack of five pens. The offer is not valid for those on government insurance plans.
Diabetes Societies Approve, but More Effort Needed
In a statement, JDRF CEO Derek Rapp said, "Lowering the cost of insulin is a critical priority for JDRF and the diabetes community, and why we have urged public and private sector actions to lower list prices and out-of-pocket costs. Eli Lilly announcing a lower-priced, generic version of insulin is an important step forward to make insulin more affordable. People with type 1 diabetes cannot go without insulin, and we need drug companies, health plans, employers, and the government to do more until everyone who needs it has affordable access to this lifesaving drug."
The American Diabetes Association's CEO, Tracey D. Brown, and Chief Scientific, Medical, and Mission Officer William T. Cefalu, MD, said, "We are pleased that Eli Lilly and Company has made an important decision to help some people with diabetes impacted by rising insulin costs. Availability of an 'authorized generic' version of their most-prescribed insulin with a 50% lower price will help those who do not use insurance to purchase insulin."
They add, "While this is a positive step, the American Diabetes Association looks forward to continuing to work with all stakeholders to implement permanent solutions that ensure affordable access to this life-sustaining medication for all who need it. Insulin is not a luxury, it is a matter of life and death every day for more than 7.5 million Americans with diabetes."