Flexibility to Make Insulin More Affordable

Mar 6, 2019

Dr Miller

The power to lower drug prices is in the hands of manufacturers. So, when Eli Lilly announces it is reducing, by half, the price of Humalog® (insulin lispro injection 100 units/mL), it’s appropriate to take a moment to understand what really is happening.

For years, Lilly has increased the price of Humalog® For years, Express Scripts has negotiated rebates from Lilly to bring down the net cost, making this insulin more accessible to people who need it. The vast majority of rebates we negotiate are delivered to our clients, who use rebate dollars to offset costs across the pharmacy benefit they offer to their members.

We often have asked drug companies to simply lower their prices. Instead, drug companies have elected to increase prices and increase rebates. This is the option drug makers have chosen for themselves and for the marketplace. We believe there should be more options, and we alone have created new options.

In the ongoing drug price debate, we have maintained a clear, unwavering position: achieving the lowest net cost for a prescription medication –whether through a rebate or a reduction in price – is best for our clients and their members. These are not just words to protect our interests; we stand by this position with the bold actions we take to ensure our clients have a pathway to the lowest net cost that best meets the needs of their plans and their members.

Only Express Scripts has the ability to innovate, build and implement market-leading formulary solutions, like our Flex Formulary, that provides greater choice to payers and patients. We created this formulary last year when drug makers began acting on our recommendation to offer lower-price versions of high-priced therapies in addition to keeping access to rebated versions of these same medications. Our Flex Formulary offers drug makers the fastest way to simply lower their prices on existing medicines. Our leadership means more affordability and more choice.

We are proud more manufacturers are following our lead to lower prices and increase affordable access to medicine, most recently with Lilly’s announcement . We are in discussions with Eli Lilly about Humalog authorized alternative, and if the net cost is lowest for plans, we will add it to our Flex Formulary.

No two payers are alike, which is why we provide clients with the flexibility to design plans that offer an affordable, high quality benefit. For some, that means leveraging discounts from rebates across all members to keep premiums low; for others, it means offering a rebate-sharing program or implementing a formulary, like our Flex Formulary, that can help lower their members’ out-of-pocket costs.

We anticipate market trends and create innovative solutions to address clients’ unique needs when market dynamics change and provide new opportunities to lower drug spending and improve care. From our industry leading SafeGuardRx platform, which has unique reimbursement strategies coupled with clinical programs that improve patient outcomes, to HealthConnect 360, our new outcomes-based model of care, to our innovative formulary solutions, we are helping plans improve care, improve access and reduce costs.

 

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