Drug manufacturer Eli Lilly & Company announced last week that it will be capping patient out-of-pocket costs for certain insulin products at $35 per month. The company’s announcement follows the passage of the Inflation Reduction Act (IRA), which instituted such a cap for Medicare beneficiaries.

“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, Lilly’s chair and CEO. “The aggressive price cuts we’re announcing today should make a real difference for Americans with diabetes. 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.”

Ricks also said that the decision came “as a result of conversations between the company and members of Congress about the cost of the medication.” The soaring cost of insulin has been a bipartisan issue in recent years, with the largest insulin manufacturers being asked to testify in front of Congress to justify high list prices. In addition to this political pressure, Eli Lilly also faces the threat of competition from outside the industry; new nonprofits, including Civica Rx in Utah and the Mark Cuban Cost Plus Drugs Company, are offering generic versions of insulin at prices ranging from $30 to $55.

The company’s move also comes after President Biden said in his State of the Union Address that the administration was interested in capping insulin at $35 per month for all consumers, including those covered by private plans. As we have mentioned, the IRA capped the cost of insulin for seniors at $35 per month, a policy that has already gone into effect. President Biden praised the drugmaker’s move in a tweet, calling on other drugmakers to also lower insulin prices as well.

The cap applies to all of Eli Lilly’s insulin products. In addition to the cost caps, the company will lower the list price for several of its products, including Humalog, this year.

Source: National Association of Benefits and Insurance Professionals