Individuals with diabetes received much-welcomed assistance when Eli Lilly announced it would lower the cost of insulin by 70% and cap what patients pay out of pocket at $35. 

White House officials said the action, driven by the momentum from the Inflation Reduction Act, could benefit millions of Americans with diabetes in all fifty states and U.S. territories. 

Meanwhile, President Joe Biden has continued calling on Congress to cap costs at $35 for all Americans.

“While the current healthcare system provides access to insulin for most people with diabetes, it still does not provide affordable insulin for everyone, and that needs to change,” said David A. Ricks, Eli Lilly’s chairman, and CEO. 

“The aggressive price cuts we’re announcing should make a real difference for Americans with diabetes,” he noted.

“Because these price cuts will take time for the insurance and pharmacy system to implement, we are taking the additional step to immediately cap out-of-pocket costs for patients who use Lilly insulin and are not covered by the recent Medicare Part D cap.”

The cost reduction should alleviate financial burdens in paying for insulin, particularly for many African Americans.

A U.S. Department of Health and Human Services study revealed that, in 2019, non-Hispanic Blacks were twice as likely as non-Hispanic whites to die from diabetes.

In 2018, African American adults were 60 percent more likely than non-Hispanic white adults to have a physician diagnose them with diabetes.

Also, in 2019, non-Hispanic Blacks were 2.5 times more likely to be hospitalized with diabetes and associated long-term complications than non-Hispanic whites.

Finally, the HHS report noted that non-Hispanic Blacks were 3.2 times more likely to receive an end-stage renal disease than non-Hispanic whites.

In addition to reducing the list price of its insulins, Eli Lilly said it is making it easier for more people with diabetes to get their insulins.

The company announced that effective immediately, it would automatically cap out-of-pocket costs at $35 at participating retail pharmacies for people with commercial insurance using Lilly insulin.

“We are driving for change in repricing older insulins, but we know that 7 out of 10 Americans don’t use Lilly insulin,” Ricks said. 

“We are calling on policymakers, employers, and others to join us in making insulin more affordable,” he added.

Ricks continued: “For the past century, Lilly has focused on inventing new and improved insulins and other medicines that address the impact of diabetes and improve patient outcomes. Our work to discover new and better treatments is far from over. 

“We won’t stop until all people with diabetes are in control of their disease and can get the insulin they need.”

A January 2023 HHS report revealed that, in 2019, about 37 percent of insulin fills for people with Medicare required cost sharing exceeded $35 per fill, including 24 percent that exceeded $70 per fill.

Nationally, the average out-of-pocket cost was an insulin fill in 2019, typically for a 30-day supply. 

On average, patients with private insurance or Medicare paid about $63 per fill.

Some of the findings from a previous study sent to Congress that looked at how important insulin is in treating diabetes were included in the report.

Researchers looked at evidence about how the price of insulin affects how well people stick with their insulin treatment and how it affects their health in the long run. 

They also looked at policy efforts to make insulin more affordable.

Additionally, the January 2023 report also found that the states with the most people with Medicare projected to benefit from the new Inflation Reduction Act insulin cost savings are  Texas (114,000 beneficiaries), California (108,000 beneficiaries) and Florida (90,000 beneficiaries). North Dakota ($805), Iowa ($725), and South Dakota ($725) have the highest average annual out-of-pocket savings.

The report shows that if the Inflation Reduction Act’s provision capping the cost of insulin at $35 for a month’s supply for Medicare beneficiaries had been in place in 2020, 1.5 million seniors across the country would have saved an average of $500 on insulin for the year. 

The insulin provisions of Biden’s new law went into effect on January 1, 2023, for Medicare Part D. Starting July 1, 2023, under Medicare Part B, beneficiary cost sharing will be limited to $35 for a month’s supply of insulin. 

Researchers estimate that 1.5 million people with Medicare would have benefited from the Inflation Reduction Act insulin cost-sharing limits if they had been in effect in 2020, with total savings to beneficiaries of about $734 million in Part D and $27 million in Part B – an average savings of approximately $500 for those Medicare beneficiaries.

“The Biden-Harris Administration is committed to lowering health care costs and increasing access to high-quality, affordable health care, and the Inflation Reduction Act is helping us do just that,” said HHS Secretary Xavier Becerra. 

“Thanks to this historic law, people who get their insulin through Medicare won’t have to pay more than $35 for a month’s supply. No one should have to skip or ration their insulin because they can’t afford it.”

Stacy M. Brown is a senior writer for The Washington Informer and the senior national correspondent for the Black Press of America. Stacy has more than 25 years of journalism experience and has authored...

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