Insulin is a lifesaving medication used to treat people with diabetes. Its skyrocketing cost is a significant concern for many individuals and families.
The price of insulin has risen so dramatically in recent years many people with diabetes can no longer afford the medication they need to survive.
This article takes a closer look at the cost of insulin with or without insurance and some tips on how to save on the cost of this life-saving drug.
The Cost Of Insulin Without Insurance
The cost of insulin without insurance can vary widely based on several factors. These factors include the type of insulin (fast-acting, intermediate, or long-acting), the brand, and the location it is purchased. Costs can rise up to $800 per month and more.
Popular brands of insulin, like Humalog, Novolog, and Lantus, are known to be expensive. In contrast, retail prices of generic insulins, like lispro and aspart, are typically half the price.
Below we have listed some popular brands and generic price comparisons.
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Manufacturer – Eli Lilly: Brand name: Humalog Generic (biosimilar) Lispro |
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Humalog 50/50 vial (10 mL; 100 iU/mL) |
$0.39 per unit |
$393.00 per vial
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Humalog 50/50 KwikPen (3 mL; 100 iU/mL) |
$0.48 per unit |
$714.87 per carton of 5 pens |
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Insulin lispro 75/25 KwikPen (3 mL; 100 iU/mL) |
$0.22 per unit |
$328.69 per carton |
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Insulin lispro 50/50 vial (10 mL; 100 iU/mL) |
$0.08 per unit |
$82.41 per vial. |
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Manufacturer – Novo Nordisk: Brand Name: Novolog Generic: Aspart |
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Novolog 70/30 vial (10 mL; 100 iU/mL) |
$0.37 per unit |
$367.69 per vial |
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Insulin aspart 70/30 vial (10 mL; 100 iU/mL) |
$0.18 per unit |
$181.67 per vial |
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Novolin 70/30 ReliOn vial (10 mL; 100 iU/mL) |
$0.03 per unit |
$25.53 per vial |
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Manufacturer: Sanofi Brand Name: Lantus Generic (Mylan and Biocon : Semglee |
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Lantus vial (10 mL;100iU/mL) |
$0.34 per unit |
$343.00 per vial |
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Semglee vial (10 mL;100iU/ml |
$0.13 per unit |
$125.73 per vial |
** Prices of the above with insurance: Free or much lower than stated above.
How Much Is Insulin If You Have Insurance?
The cost of insulin with insurance can vary depending on your insurance plan, the type of insulin you use, and the amount you need.
Some insurance plans may fully cover the insulin cost. In contrast, others may require you to pay a co-pay or deductible for each prescription.
If you have a traditional insurance plan, your co-pay for insulin may be a fixed amount per prescription. Co-pay amounts can range from $10 onwards. The co-pay may be waived if you reach your plan’s annual out-of-pocket maximum.
Some insurance plans also require you to pay a percentage of the cost, known as coinsurance.
If you have a high deductible plan (HDHP), you may have to pay the full cost of insulin until you reach your deductible. After you reach your deductible, your insurance may cover a portion of the price, and you may be responsible for paying a coinsurance amount.
What Influences The Cost Of Insulin?
Pharmaceutical Companies
Overall, the high cost of insulin is a complex issue that involves multiple factors, including the cost of research and development, marketing, and negotiating with insurance companies and pharmacy benefit managers.
Pharmaceutical companies influence the cost of insulin in several ways, including:
- Companies have a monopoly on producing and selling their insulin products for a certain number of years due to patent protection. This means pharmaceutical companies can set prices without competition.
- Developing and producing insulin is expensive, and pharmaceutical companies factor in these costs when setting prices.
- Companies spend large amounts of money on marketing and advertising their insulin products, which can also drive up costs.
The Government
While the government does not directly set the cost of insulin, several government policies can influence the cost.
The Food and Drug Administration( FDA) regulates the approval and marketing of drugs, including insulin. This process can impact the cost of drugs by giving certain companies exclusive rights to sell the drug for a period of time.
The U.S. government’s Medicare and Medicaid programs negotiate with drug companies to determine the prices they will pay for medication, including insulin. These negotiations can impact the overall cost of insulin for consumers.
The U.S. government can also impact the cost of insulin by setting regulations around the import and export of drugs, including insulin, from other countries.
Brand Name
The brand name of insulin can influence its price because certain brands have patents or exclusive marketing rights for their specific formulation of insulin, giving them a legal monopoly on the market and the ability to set higher prices.
A pharmaceutical company can hold exclusive patent protection for between ten and twenty years, depending on the country in which the drug is patented and the regulatory environment.
After the patent has expired, other companies may produce generic versions of the drug.
Generic drugs are cheaper because generic manufacturing does not carry the costs of researching, developing, and marketing a new drug.
Brands invest heavily in these areas and need to recoup their costs and make a profit. This results in higher prices for the brand name drug than for the generic versions that do not have these costs.
Generics’ availability increases market competition and typically results in more competitive prices.
4 Tips For Saving Money On Insulin
If you need insulin but don’t have insurance, here are some ways to save some money when buying this drug.
Use A Manufacturer’s Savings Card
Several manufacturers offer savings cards or patient assistance programs for insulin. These cards help reduce the cost of insulin for patients by providing discounts on the retail price of the medication.
Major insulin manufacturers like Novo Nordisk, Eli Lilly, and Sanofi offer copay cards for patients with or without insurance.
It is always best to check with the specific manufacturer for more information on their insulin savings programs and eligibility criteria.
Shop Around
Compare prices at different pharmacies. Insulin prices vary widely between stores, so it is worth checking prices in a few other places.
Many pharmacies offer discount cards or coupons that lower the cost of insulin.
Ask About Generic Options
Some types of insulin have generic versions available. As mentioned, generics are typically much cheaper than the brand name version.
Speak to your doctor about prescribing a generic instead of brand-name insulin.
Generic refers to biosimilar versions of name-brand insulins sold at significantly lower prices.
Contact Your Insurance Company
Find out if your insurance policy excludes certain types of insulin or offers better cover for other types. If the insulin you are taking falls under an exclusion, talk to your healthcare provider about alternatives.
Some insurance companies will accept a “prior authorization,” where your doctor writes a letter of motivation explaining your need for specific insulin.
Ask your insurance if they have any special programs for people with diabetes like this one from Cigna.
Conclusion
If you depend on insulin to manage your diabetes, access to affordable insulin is critical. Research shows that access to low-cost or free insulin improves the long-term health of people with diabetes and prevents diabetes complications and expensive emergency room visits.
The best way to get affordable insulin is with health insurance coverage that meets your needs.
Our experienced agents at Enhance Health will explain your options and help you choose the health insurance that covers the cost of your insulin and diabetes care.
