Generic Insulin Drug Pricing, Access Still Pose Problems for Uninsured

July 17, 2023 - Following up on a promise that Eli Lilly made in 2019, the offices of Senators Elizabeth Warren (D-MA), Richard Blumenthal (D-CT), and Raphael Warnock (D-GA) conducted a survey on the drug pricing and availability of its generic insulin, Insulin Lispro.

“Overall, this report finds that far too many patients still do not have ready access to affordable insulin, and that federal legislation is needed to address ongoing problems with high costs and confusing drug company and pharmacy policies to ensure all Americans can access this lifesaving drug,” the report shared.

The senators’ offices conducted the survey from June 9 to June 28, 2023. They called 332 independent and chain pharmacies in every state, the District of Columbia, and Puerto Rico.

The survey callers requested information about Eli Lilly’s Insulin Lispro, which is the generic version of the brand-name insulin Humalog, including availability, pricing, and whether pharmacies offered information about Eli Lilly’s generic alternative.

In 2019, the pharmaceutical company Eli Lilly stated that it planned to make insulin more affordable for Americans with its new Insulin Lispro. But the senators’ offices found that the pharmaceutical company did not live up to its promise.

More than four in ten pharmacies in the survey did not have generic insulin available (43 percent). Nearly eight out of ten pharmacies reported having the brand name insulin available (78 percent), demonstrating the accessibility challenges of generic insulin compared to brand name insulin.

Almost six out of ten independent pharmacies did not have Insulin Lispro in stock (56 percent), and almost seven out of ten independent pharmacies had the brand name insulin in stock (76 percent). Nearly a third of the chain stores did not have the generic in stock (32 percent), while over eight in ten chain pharmacies had Insulin Humalog in stock.

Of the chain pharmacies that the senators’ officers surveyed, Rite Aid and Walmart were most likely to carry the generic brand (82 percent, respectively). CVS Pharmacies was least likely among the major chain pharmacies to carry the generic version (22 percent).

The survey identified one significant improvement from 2019 to 2023. In 2023, 100 percent of the pharmacies surveyed indicated that they could order Lispro and have it available within a couple of days. Four years earlier, less than a third of pharmacies reported this capability (31 percent).

Not only is availability challenging, but the price of insulin remained unaffordable for many Americans. While Eli Lilly’s list price for the drug was $25, the average cost of Lispro at the pharmacy—without health insurance coverage—was $97.51. A third of the pharmacies priced it at $164 or more, with the most expensive price tag hitting $330.

Chain pharmacies were the primary perpetrators of high insulin pricing. On average, uninsured individuals paid $126.06 at chain pharmacies. Across the major chain pharmacies interviewed, CVS Health offered the drug at the lowest cost ($38.52), whereas Walgreens charged $165.61.

“This is a deeply troubling finding, revealing that the pharmacies offering the most affordable Insulin Lispro were the least likely to have it in stock, making it even harder for patients to find affordable insulin,” the report explained.

Patient education regarding generic insulin is low. Patients may not know that there is a generic alternative to Humalog, and pharmacists may not mention it when patients request insulin. As a result, patients have higher drug spending because they purchase the brand name drug instead of the generic.

“The findings of this investigation reveal that Eli Lilly’s promises of affordable, accessible insulin have not been realized for uninsured patients across the country,” the report concluded.

“Congress must take additional steps to rein in excessive prices, including by applying a $35 monthly copay cap for insulin for all patients. Because uninsured patients are most affected by high prices, it is critical that any solution Congress considers also include protections for this population to ensure that no one in the U.S. is ever forced to choose between the insulin they need to survive and their livelihood.”

In March 2023, Eli Lilly announced that its Insulin Lispro Injection would be available for $25 per vial by May 1, 2023, and that the price of its Humalog and Humulin products would drop by 70 percent by the fourth quarter of 2023.