Eli Lilly CEO says $35 for monthly insulin ‘should be the new standard in America’

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Eli Lilly CEO says $35 for monthly insulin ‘should be the new standard in America’
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Eli Lilly & Co. said Wednesday it's capping out-of-pocket insulin costs at $35

Eli Lilly’s announcement that it will cut the price of insulin for people with commercial health insurance — capping out-of-pocket insulin costs to $35 — highlights just how much money people are paying on these injections.

The $35 price tag is the same monthly limit that Medicare beneficiaries now pay on a month’s supply of insulin, after rule changes from last year’s wide-ranging tax, climate and healthcare law, known as the Inflation Reduction Act. Almost 2.6 million Americans use Lilly insulin, according to a company spokesperson. More than one-third of those recipients get it via Medicare Part D while almost 43% of Lilly insulin users access it through commercial insurance, third-party assistance or pay cash, the spokesperson said. The price cap will be available at 85% through local and national retail pharmacies, the spokesperson noted.

People without insurance for at least a year were paying an average $123 per fill, according to the January report. If the cost-sharing caps were in effect during 2020, researchers projected 1.5 million Medicare beneficiaries could have saved around $500 annually. But insulin users likely also have other medical costs competing for their money and out-of-pocket costs are just one part of a person’s healthcare costs, Cox said. “The $35 dollar threshold is somewhat arbitrary…It’s not necessarily the magic number that equates to affordability.”“‘As a clinician, I am happy to see these price reductions. I do think that they will help some of my patients with diabetes who struggle to afford insulin.

“Reducing the price of insulin will directly help patients who pay for insulin entirely out of pocket, those who have high deductible plans, and those who pay substantial co-insurance,” Lipska told MarketWatch. Though there’s been “significant progress on the issue of insulin affordability, including Medicare’s new out-of-pocket cost cap on insulin, state copay caps, and patient assistance developments from insulin manufacturers, we know that our work is not done,” Henderson said.

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