Cutting down or rationing insulin has dire consequences for all type 1 as well as type 2 diabetics dependent on insulin. Working in a busy practice alongside an endocrinologist with predominantly type 1 diabetic patients, I’ve seen the team behind our doctors working hard to keep insulin affordable for patients. Here is what I’ve learned from the best.
Steps for insured patients
If you’re about to take insulin, choose one that’s preferred:
- Call your insurance first to find their preferred insulin products. “What’s my preferred insulin?” is the first question you should ask.
- Find your preferred pharmacy. Is it retail? Mail order? Along with what insulin is preferred, you’ll want to ask your insurer, “What’s my preferred pharmacy?”
If you’re already taking insulin, but NOT one that’s preferred, here’s what you can do:
If you and your doctor don’t want to switch your insulin, this is where your endocrine or internist’s office can fill out a “prior authorization” stating that you have to be on your current insulin due to reasons like fluctuating blood sugars, intolerance to other agents, etc. Most of the time with a prior authorization filled out by your doctor’s office, that will work.
Additionally, remember to take advantage of savings cards listed below. Savings cards are often billed on top of your insurance, so your physician’s office will still have to get your insulin covered with a prior authorization if it’s not a preferred choice. This may take two weeks or longer. It’s possible for your insurer to deny the original authorization request, in which case, you’ll have to submit an appeal, so leave some time.
Options for uninsured patients
First, remember to check for coupons like those at Goodrx.com and patient assistance programs offered by insulin manufacturers. Major insulin manufacturers in the US offer patient assistance programs to uninsured patients and patients on Medicare Part D, so they can get their insulin for free. These programs have certain eligibility restrictions, requirements and limitations, so be sure to read the fine print before using them. More information is available below.
Then, patients sometimes ask if they can switch to an insulin that may be cheaper out of pocket. Insulins come in certain classes, like rapid-acting or long-acting insulins. But even within these classes, individual insulins may have different peak times and durations of effectiveness. While there are standard conversion recommendations when changing from one insulin to another, this process requires close observation from a physician, especially if the patient has type 1 diabetes. It may also involve the use of a continuous glucose monitor—like Dexcom, Libre, and Eversense sensors—which are relatively new to the field of diabetes treatment.
Savings opportunities from insulin manufacturers
Major insulin manufacturers offer savings to patients through patient assistance programs and copay cards.
Patient assistance programs (uninsured or Medicare Part D patients)
Patient assistance programs, primarily for those who are uninsured or are enrolled in Medicare Part D, can make insulin products free to eligible patients. Information on these programs from the three largest insulin manufacturers in the US—Eli Lilly, Novo Nordisk and Sanofi Aventis—is listed below:
|Lilly Cares||Humulin N, Humulin R U100 or U500, Humulin 70/30, Humalog 50/50, Humalog 75/25, Humalog U100 or U200, Basaglar||www.lillycares.com|
|Novo Nordisk Patient Assistance Program||Tresiba U100 or U200, Levemir, Fiasp, Novolog, Novolog 70/30, Novolin N, Novolin R, Novolin 70/30||www.novocare.com|
|Sanofi Patient Connection||Admelog, Lantus, Soliqua 100/33, Toujeo||www.sanofipatientconnection.com|
Novo Nordisk offers free insulin for up to 120 days. Patient assistance through Sanofi Aventis and Eli Lilly’s programs can last for up to a year.
Some manufacturers also offer vouchers—available at doctors’ offices—for a free, but limited, sample of insulin. Eli Lilly, for example, offers vouchers for five vials of any of their insulin products for free.
Savings cards (insured patients not on Medicare)
Eli Lilly Savings Cards
Eli Lilly offers savings cards for three of their insulin products: Basaglar, Humalog U200 Kwikpen and Humulin R U500. These cards can reduce copays to as little as $15 to $25 for the first 24 prescriptions filled. Remember, even if you have a savings card, you may still need to submit a prior authorization filled out by your doctor if the insulin you need is not preferred.
Novo Nordisk Savings Card
The Novo Nordisk Savings Card allows patients with insurance to save on Fiasp, Levemir, Novolog, Novolog 70/30, Tresiba and Xultophy. It offers patients the opportunity to pay no more than $25 for a 30-day supply of many of these products and on refills for up to two years. The deal also comes with a free box of Novo Nordisk needles.
Long-acting Tresiba often requires a prior authorization by your doctor’s office. Pro tip: Tresiba is used at lower doses than Lantus (80% of a Lantus dose), so a smaller dose technically means a savings benefit.
Short-acting Fiasp, commonly used for people with type 1 diabetes, also often requires a prior authorization. Successful prior authorization arguments may include fluctuating blood sugars, injection site reactions and faster onset resulting in improved blood sugar control.
Sanofi Aventis Savings Cards
Savings cards from Sanofi Aventis can reduce copays to as little as $0 and are specific to each of their insulin products. Here are the direct links to the savings cards: