Sept/Oct Blog: Avenues for Insulin Access in COVID Era

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)

Minnesota governor signs emergency insulin access bill

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 ProgramCovered InsulinGeneral EligibilityCOVID SpecificProof incomeTo obtain application
Lilly CaresHumalog, Basaglar, Humulin, Humalog MixMust not have prescription coverage, or has Medicare Part D; must be meet total household guidelinesRequired1-833-808-1234 https://www.lillycares.com/lilly-cares-application  
Novo Nordisk NovoCareFiasp, Novolog, NovoRapid, Levemir, TresibaMust 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 ProgramAdmelog, Apidra, Lantus, ToujeoMust 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 LevelNot required1-855-984-6302 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 ProgramCovered insulinAmount of insulinWho is eligibleTo 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 neeedThose 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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