Millions of Americans are still unemployed and facing financial hardship as a result of the COVID-19 pandemic, especially those from underrepresented or underserved populations. as recently as October 2021, about a third of Americans reported difficulty paying for household expenses, including medications.
Insulin, a diabetes drug taken by more than 9 million Americans, has made headlines in recent years for skyrocketing prices. Unfortunately, insulin prices have only come down slightly since the start of the pandemic.
Reading: How much is insulin with insurance
From 2014 to 2019, the average cash price of insulins increased significantly: the average price per unit of insulin increased 54%, from $0.22 to $0.34. then from January 2020 to October 2021, it fell 5%, from about $0.33 to $0.31.
A unit of insulin is the most basic measure of insulin used for dosing. An insulin medication that has a concentration of u-100 has 100 units of insulin per milliliter.
However, not all insulins experienced price declines. recently approved generics such as insulin lispro and insulin aspart have provided more affordable options for some patients taking rapid-acting and mixed insulins. however, retail prices for other insulins such as afrezza, xultophy, and soliqua continue to rise. Even select versions of long-standing Humalog and Novolog insulins saw price increases during the pandemic.
With FDA approval of insulin glargine in July 2021, goodrx will continue to monitor pricing as more data becomes available. It’s also important to note that manufacturers have responded with patient assistance programs, copay cards, and COVID-19 relief efforts during the pandemic. Several states have passed laws to cap monthly insulin costs. and Medicare piloted a program to cap insulin costs for its patients, something Congress is considering expanding to all insured patients with the Build Back Better bill that passed the House but is awaiting action in the Senate. .
So, what is the current situation of insulin prices? And how much can you expect to pay for your insulin? The GoodRx Research Team conducted a follow-up analysis of 28 insulins across all insulin manufacturers and types, including short-acting, intermediate-acting, rapid-acting, and long-acting insulins. Here, we’ll walk you through how each insulin stacks up and how you can get the best deal on these life-saving medications.
this goodrx analysis is based on a representative us sample. uu. prescription fills (not goodrx refills) and comes from various sources, including pharmacies and insurers. reported prices per unit of insulin are based on cash prices, so-called “usual and customary” prices or pharmacy retail prices (not including insurance copays or coinsurance).
generics and biosimilars are driving down the overall price of insulins
Since 2019, the overall retail price of insulins has decreased by approximately 5%. most of this decline can be seen as a result of recent generic and biosimilar approvals.
in 2019, eli lilly launched the first generic insulin, insulin lispro, the fast-acting counterpart to the popular humalog insulin. Since then, the FDA has approved generic versions of Humalog 75/25 (insulin lispro 75/25), Novolog (insulin aspart), Novolog 70/30 (insulin aspart 70/30), and, more recently, Lantus (insulin glargine).
Retail prices for generic insulin lispro and insulin aspart are currently about half those of humalog and novolog, respectively. the same occurs with the generic mixed insulins, insulin lispro 75/25 and insulin aspart 70/30, compared to humalog 75/25 and novolog 70/30, respectively.
Generics have been instrumental in reducing costs for some patients. Instead of paying a retail price of more than $700 for a 5-pack of humalog kwikpens, for example, patients can now pay close to $300 for a 5-pack of generic insulin lispro kwikpens. however, we have seen that limited insurance coverage may prevent some patients from accessing these savings.
Like generics, follow-on products have also helped lower insulin prices overall. generics contain the exact replicas of the active ingredients in a brand name drug. but biological drugs like insulin are almost impossible to recreate. therefore, manufacturers sometimes make close copies of them, known as “follow-ups” or “biosimilars.” biosimilars tend to be more expensive than generics but less expensive than brand names.
For example, Admelog was approved as a follow-up to Humalog in 2017. The average retail price of a 3 mL vial of Admelog is now $54, compared to $123 for the same size vial of Humalog. Lantus also has a follow-up: Basaglar, approved in 2016. Based on price per unit of insulin, Basaglar is 23% cheaper than Lantus. In July 2021, the FDA also approved insulin glargine, a biosimilar to be used interchangeably with Lantus. In its first quarter, retail prices for a unit of insulin glargine were about 60% lower than retail prices for a unit of lantus.
traditional insulins are cheaper than modern insulins
Average retail prices for novolin and humulin (traditional short- and intermediate-acting insulins) have declined or remained stable, while prices for modern rapid- and long-acting insulins continue to rise. On average, traditional insulins now cost less than half of what modern insulins cost.
why? Historically, traditional insulins have been cheaper than their newer competitors. Modern insulins offer better blood sugar control, but they are synthetic analogs of traditional insulins, making them more difficult to produce.
Furthermore, when the patents on humulin and novoline expired around the year 2000, manufacturers eli lilly and novo nordisk had to try new pricing strategies to stay competitive.
In 2017, for example, Novo Nordisk partnered with CVS to offer Novolin at approximately 80% less than its list price. Both Novo Nordisk and Eli Lilly have also worked with Walmart to offer deep discounts on Novolin and Humulin in Walmart’s Relion line of insulin products.
However, retail partnerships have not been their only strategy. Eli Lilly had been increasing Humulin prices every 6 months until May 2017, when they decided to stop further increases. in fact, the prices of traditional humulin and novoline insulins have been fairly stable since then.
novolin r and novolin n are currently the cheapest traditional insulins, with average unit prices as low as $0.03.
vials are cheaper than newer dispensers
In 1985, Novo Nordisk introduced the first insulin pen, making it more convenient for patients to store and self-inject insulin, but it came at a price. today, retail prices for rapid-acting insulins can be almost 40% more expensive if you opt for pens instead of vials.
The new dispensers make insulin more expensive. we’re seeing it again with afrezza, the only insulin that’s delivered as an inhalable powder. a unit of insulin de afrezza can cost up to 20 times the price of other rapid-acting insulins. Average retail prices for afrezza have also continued to rise during the pandemic. Afrezza’s maker, Mannkind, offers the drug at reduced costs through its direct purchase program.
These are the retail prices for rapid-acting insulins as of October 2021:
new product features can come at a high price
newness can translate into higher prices (as we saw with afrezza), but not always. we recently got three new insulin combination drugs: xultophy, soliqua 100/33 and fiasp. Tresiba, an ultra-long-acting insulin, has also entered the market in recent years.
xultophy and soliqua contain a long-acting insulin and another non-insulin diabetes medicine. xultophy is a combination of insulin degludec plus liraglutide (same active ingredient in victoza), and soliqua is a combination of insulin glargine plus lixisenatide (same active ingredient in adlyxin). Average retail prices for Soliqua and Xultophy are more than double the price of cheaper alternatives like Basaglar and Tresiba, which have the exact same insulin ingredient.
Approved June 2020, Lyumjev contains insulin lispro, the same insulin in humalog, and some additional ingredients. In studies, Lyumjev was found to begin lowering blood glucose earlier than Humalog, although this does not necessarily make Lyumjev more effective than Humalog or generic insulin lispro in lowering blood sugar. Currently, prices per unit for lyumjev’s insulin are about double those for generic insulin lispro.
fiasp contains insulin aspart, the same insulin in novolog, but also has vitamin b3. Like Lyumjev, the added ingredient in Fiasp can speed up insulin absorption. interestingly, the retail prices of fiasp and novolog are about the same per unit of insulin.
Then there’s tresiba, an ultra-long-acting insulin that stays active for up to 42 hours. for this unique property, its average retail price is about $630 for a box of 5 kwikpens (100 iu/ml).
Along with these new formulations, insulin manufacturers have also begun offering their insulins in higher strengths to make them more convenient for people who need more insulin than average. humulin r, humalog, and tresiba come in higher-strength versions, and toujeo is a higher-strength version of lantus. At first glance, their prices may seem high, but they actually have the same retail price per unit as their lower concentration counterparts.
In late 2017, long-acting insulins began to become more expensive, after enjoying stable prices since 2015. Prices for most long-acting insulins have been stable since 2019, but xultophy prices and soliqua have remained. increase this is how prices are as of October 2021:
ways to save on insulin
It’s hard to predict where drug prices will be in the future, but if you use insulin, we hope our review will give you some ideas on how to talk to your provider about affordable options. here are more ways to save:
1) Use a manufacturer savings card or patient assistance program. Major insulin manufacturers eli lilly, novo nordisk, Sanofi-aventis, and mannkind offer copay cards and payment programs. patient assistance for patients with and without insurance coverage. In many cases, these programs can lower your out-of-pocket costs to as little as $0 per month. For more information, simply search for your medication on goodrx.com and click on “saving tips” for more details.
2) Shop around. goodrx offers discounts on insulin medications, which can save you up to 50% off full retail price. At goodrx.com, you can also compare insulin prices at different pharmacies in your area and find information about discount programs at specific pharmacies.
3) Appeal your coverage. If you have insurance and your plan doesn’t cover the insulin you need, ask your doctor about filing an appeal. Your insurance company may require prior authorization or step therapy before you can fill your prescription, but it’s worth a try if you want your insulin covered.
co-collaborators: diane li, hannah mcqueen, swetha pola
This analysis is based on a representative US sample. uu. prescription fills (not goodrx refills) and comes from various sources, including pharmacies and insurers. reported prices per unit of insulin are based on cash prices, so-called “usual and customary” prices or pharmacy retail prices (not including insurance copays or coinsurance). Note: We set a threshold for a drug to be included in parcels by requiring a claim count threshold per quarter. furthermore, a drug must have continuous quarterly data (with no gaps), for inclusion in the plots. for inclusion in the tables, we require a higher claim threshold for a year of claims.
a note on insulin use
In general, it takes 1 IU (insulin unit) to lower blood glucose by 50 mg/dl, although it depends a lot on each individual . someone with type 2 diabetes can start with 1 iu of insulin per 1 kg to 2 kg of body weight per day, which is equivalent to about 40 units (ius) of insulin per day for a 70 kg person.
Treatment for type 2 diabetes often does not involve insulin medications, or only an intermediate or long-acting type of insulin, since type 2 diabetes is a disease in which the body is resistant to insulin. the effects of insulin. however, type 1 diabetes is an autoimmune disorder that kills the pancreatic cells that produce insulin, so treatment requires more insulin of different types. It is common, for example, for a person with type 1 diabetes to use mealtime insulin (rapid or short-acting) along with basal insulin (intermediate or long-acting).