Randy, a 30-year-old male, is discharged from his local hospital for diabetic ketoacidosis and a new diagnosis of type 1 diabetes. Unfortunately, Randy recently lost his health insurance and prescription drug coverage after being laid off his job due to COVID. He goes to the local pharmacy to pick his new prescriptions for basal and bolus insulin where he is told that the cost would be $500, Randy’s eyes practically popped out of his face. What??!! How could this be!!! Are you serious??!! Randy is not alone as persons with diabetes on insulin therapy who have lost their jobs due to COVID will encounter a similar experience. As a pharmacist myself, I am compelled to point out it is not the pharmacist or the pharmacy’s fault for the price.
What is Randy to do? If he goes without his insulin, he will end up back at the hospital with a hyperglycemic (high glucose) emergency. Well, avenues exist for assistance with affording insulin — while they are not perfect, they are a step in the right direction. The three primary insulin manufacturers in the country, Lilly, Novo Nordisk and Sanofi, have patient assistance and copay card programs. Below are the phone numbers to call to see if you qualify.
Lilly Diabetes Solution Center (1-833-808-1234)
Novo Nordisk NovoCare (1-844-668-6463)
Sanofi Patient Savings Program (1-855-984-6302)
Before calling, it will be helpful to know and have written down the information required to apply. The information is very basic: contact information, date of birth, household income, active prescription at the pharmacy, cost of insulin for a month supply, amount of deductible, method of insulin administration (vial/pen, pump, syringe), dosage, amount of insulin you have on hand, type of insurance and whether you are a U.S. resident.
One unique program is Novo Nordisk NovoCare Immediate Supply (insulin at no cost to person with diabetes). This program covers all NovoNordisk insulin (i.e. NovoLog, Fiasp, Levemir, Tresiba) and is designed to prevent rationing of insulin. Person may or may not have health insurance, must have a valid prescription for covered insulin and attest to financial need. It can only be used once in a lifetime. To obtain an immediate supply card, https://www.novocare.com/insulin/immediate-supply.html or call 1-844-668-6463.
So what programs are out there for insulin patient assistance?
|Patient Assistance Program||Covered Insulin||General Eligibility||COVID Specific||Proof income||To obtain application|
|Lilly Cares||Humalog, Basaglar, Humulin, Humalog Mix||Must not have prescription coverage, or has Medicare Part D; must be meet total household guidelines||—||Required||1-833-808-1234 https://www.lillycares.com/lilly-cares-application|
|Novo Nordisk NovoCare||Fiasp, Novolog, NovoRapid, Levemir, Tresiba||Must not have prescription coverage, or has Medicare Part D; persons who are Medcaid eligible who have applied for and been denied Medicaid; total household income must be at or below 400% of the federal poverty level||Documentation showing loss of healthcare benefits (job termination notice, job status change, proof that COBRA benefits being offered); no proof income; if approved, will receive a 90-supply on insulin. NovoCare will check back with person to determine continued eligibility.||Required (but NOT for those impacted by COVID-19)||1-844-668-6463 https://www.novocare.com/content/dam/diabetes-patient/novocare/redesign/General/PAP-Application-EN.pdf|
|Sanofi Connection Program||Admelog, Apidra, Lantus, Toujeo||Must have prescription coverage, not eligible for Medicare or Medicaid; for those enrolled in Medicare Part D, must also spend at least 2% of annual household income on prescription medication covered through Part D in the current calendar year; annual household income of >/= 400% of the current Federal Poverty Level||—||Not required||1-855-984-6302 http://www.sanofipatientconnection.com/|
So what copay card programs are available (note: COVID has led to changes in copay card programs — positive change)
|Copay Card Program||Covered insulin||Amount of insulin||Who is eligible||To obtain card|
|Lilly $35/month||Humalog, Basaglar||Those without health insurance, and those covered by commercial/private insurance (including high deductible plans)||Call Lilly Diabetes Solution Center at 1-833-8081234|
|Lilly 40% discounted price through BlinkHealth||Those without health insurance, and those with high deductible plan||https://www.blinkhealth.com/|
|Novo Nordisk My$99Insulin Program||Fiasp, NovoLog, Levemir, Tresiba||Up to 3 vials or 2 packs of insulin pens, or any combinations of insulin from NovoNordisk||Those without health insurance, and those covered by commercial/private insurance (including high deductible plans)||Call 1-844-668-6463 or visit https://www.novocare.com/|
|Sanofi ValYou Savings Program ($99/Month)||Admelog, Apidra, Lantus, Toujeo||Up to 10 boxes of pens or 10 vials (can be a mix of long acting and short acting as neeed||Those without prescription medication insurance||Call 1-855-984-6302 or visit https://www.admelog.com/insulins-valyou-savings-program?utm_source=vanityurl&utm_medium=redirect&utm_campaign=valyou|
Other options also exist including purchase human insulin (Humulin R and NPH) without a prescription from Wal-mart (Reli-On brand for $25 per vial), generic version of insulin lispro (Humalog) ($137.35/vial and $265.20 for pack of five KwikPens) and asking your providers office for samples. From experience, I would much rather a patient contact the clinic office if they need a prescription sample to help get them through as opposed to going without insulin. This will allow the provider to help them determine the best avenue for insulin access.
Back to Randy, the pharmacist helped him get access to his basal bolus insulin through the NovoNordisk Immediate Supply program, and helped to connect him with a local indigent (safety net) clinic. The pharmacist asked Randy to call if he needed anything or had difficulty getting connected with the indigent clinic.
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