- Jorge Ribas, The Washington Post via Getty Images
- Insulin is a lifesaving product for individuals with diabetes. But it’s also become incredibly expensive, sometimes prohibitively so for patients.
- A new program from the health company Express Scripts could soon make insulin available to patients at $25 for a monthlong supply, at most.
- Express Scripts and middlemen like it have been accused of driving drug prices up. The latest announcement comes ahead of a congressional hearing about the role of these middlemen.
Insulin is a lifesaving product for many individuals living with diabetes – it’s also incredibly expensive.
Some patients haven’t been able to afford their prescriptions, or have been forced to riskily ration their supply.
A new program from the health company Express Scripts, which is owned by health insurer Cigna, aims to change that by maxing out how much individuals with diabetes pay for a monthlong supply at just $25.
Patients across Express Scripts plans today pay $41 out-of-pocket on average, but those with “high-deductible” health plans are often exposed to even higher costs. The shift could apply to more than 700,000 people, and especially benefit those with high-deductible plans, potentially saving them $750 or more on average.
The company came up with the idea because “we have people with diabetes who take insulin who are having trouble affording their insulin,” said Dr. Glen Stettin, Express Scripts’ chief innovation officer. “And we see an opportunity to do something about that.”
Six million Americans rely on insulin each day, according to the American Diabetes Association, and the escalating cost of insulin has become a major problem for them. Frequent fluctuations in price also make it hard for individuals with diabetes to plan for the future.
- Shayanne Gal/Business Insider
The issue has also caught the attention of Congress. The Senate Finance Committee has called Cigna/Express Scripts and companies like it to appear at an April 9 hearing about drug prices, where they’re likely to face some tough questions.
Asked about this, Stettin said that the timing of the new program was “serendipitous” but the initiative has been in the works for “a while.” Express Scripts has also launched other diabetes programs in recent years, including one last year, “Inside Rx,” for uninsured and underinsured patients, he said.
Who is, and isn’t, eligible
Importantly, the new program is only being offered to companies that contract with Express Scripts to negotiate down drug prices. Express Scripts is the largest such player in the country.
Those who get health insurance through government programs like Medicare and Medicaid won’t be eligible. Employers will also have to opt into the program, but Stettin says that there won’t be any additional costs for most employers.
Express Scripts was able to negotiate with insulin makers to make this program possible, Stettin said. The company is working with drugmakers – which include Eli Lilly, Novo Nordisk and Sanofi – to make all forms of insulin available, but doesn’t yet have a specific list of products.
And the combined muscle resulting from the two companies’ $67 billion merger last year helped with negotiations, he added.
“We’re able to do some things in a coordinated manner that really help us in our discussions with pharmaceutical manufacturers, and this is an example of that,” Stettin said.