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The
new co-pay scheme covers most of Lilly's insulins, including
widely-used Humalog injection, and can be availed by people with
commercial insurance as well as those without insurance.
"Enabling a $35-per-month insulin co-pay regardless of
employment status will help many Americans in this difficult
time," said CEOs Aaron Kowalski and Thom Scher of non-profit
organization JDRF-Beyond Type 1 Alliance.
However, patients with government insurance such as Medicaid,
Medicare, Medicare Part D or any State Patient or Pharmaceutical
Assistance Program are not eligible for the scheme, Lilly said.
The cost of insulin, a life-sustaining medicine for people with
type 1 diabetes, nearly doubled from 2012 to 2016. Individuals
with high-deductible health insurance plans often face thousands
of dollars of out-of-pocket costs before their insurance starts
paying.
Major insulin makers Lilly, Sanofi SA and Novo Nordisk have
lowered the costs of their diabetes drugs to counter heavy
criticism from lawmakers and patients.
Many pharmacy benefit managers like CVS Health Corp, Cigna Corp,
and UnitedHealth Group Inc already offer coverage plans in which
patients pay discounted or zero out-of-pocket costs for insulin
and other expensive diabetes treatments.
On average, people enrolled in the federal healthcare program
pay about $675 per year for insulin.
Last month, the Trump administration unveiled a plan to limit
the out-of-pocket cost for insulin to $35 per month for people
who are enrolled in Medicare. The government plans to test the
new pricing in 2021.
(Reporting By Mrinalika Roy in Bengaluru; Editing by
Ramakrishnan M.)
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