Lilly Diabetes announced this morning it would cut the price of its insulin to $35. What does this really mean? How long will it last? Why are those with government insurance left out?
Stacey asks your questions and gets answers from Lilly's US Insulin Brand Leader, Andy Vicari.
Here's the Full Lilly News Release (link)
From the press release:
“In response to the crisis caused by COVID-19, Eli Lilly and Company (NYSE: LLY) is introducing the Lilly Insulin Value Program, allowing anyone with commercial insurance and those without insurance at all to fill their monthly prescription of Lilly insulin for $35. The program is effective today and covers most Lilly insulins including all Humalog® (insulin lispro injection 100 units/mL) formulations.”
That’s right. Lilly is putting the price of insulin – including Humalog – at $35. You need a coupon, but it’s for anyone with or without commercial insurance, except for those on Medicaid.
“The savings can be obtained by calling the Lilly Diabetes Solution Center at (833) 808-1234. The Solution Center is open 8 am to 8 pm (EST) Monday through Friday. Representatives at the Solution Center will help people with diabetes obtain a card in the most convenient way for them, including through email or the U.S. mail. A card can typically be received within 24 hours by email. If you already have a co-pay card from the Lilly Diabetes Solution Center for an amount higher than $35, no action is necessary. Active co-pay cards have been re-set to a $35 co-pay.”
Link to Stacey's conference call March 16th with Andy Vicari
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Episode Transcript:
Stacey Simms 0:06
Welcome to a bit of a breaking news episode of Diabetes Connections. I'm your host, Stacey Simms and I wanted to jump on as soon as possible. And talk about the news from fully diabetes this morning and this is April 7 2020.
I'm going to read right from the press release and then we're going to jump into an interview I was able to do with Andy Vicari, who is the US insulin brand leader at Eli Lilly. So as you may have already heard on social media, or on the news, this is directly from the press release. I'm just going to read what it says here, “In response to the crisis caused by COVID-19 Eli Lilly and company is introducing the Lilly insulin value program, allowing anyone with commercial insurance and those without insurance at all to fill their monthly prescription of Lilly insulin for $35. The program is effective today. covers most Lilly insulin, including all humalog formulations.”
So that's right, Lily is putting the price of insulin, including Humalog at $35. Now, you need a coupon. But this is for anybody with or without commercial insurance except for those on Medicaid, and government insurance. I'm going to link up the entire release in the episode homepage. I will be putting the phone numbers, the call center information, pretty much anything you need. And let me know if I'm missing anything at the episode homepage at diabetes dash connections.com. And as always, there is a transcript of the interview you're about to hear.
If you are brand new to the show. I'm really glad you found us I hope you continue to listen. I am a parent of a child with type one. My son was diagnosed 13 years ago right before he turned two. And my background is in broadcast journalism. So I hope this is an interview that gives you the information that you would ask if you had Andy Vicari on the phone yourself.
I also I should say if you're new to the show that three weeks ago, I was on a conference call with Lilly, and I was able to ask a question about insulin pricing. We played that bit of the conference call last week. And while I do not get me wrong, I do not think that because I asked this question, that is why this change happened. But I think if you go back and listen to the question and answer, where I did ask, why not at this devastating time, during this world health crisis, why not? Do it now? Why not cut the price to $35 or $25? I had pushed for if you hear that question, and then Andy Vicari’s answer, I do think it gives you some context as to what has changed. But he talks about that here as well.
There's going to be a lot written about this. There is going to be a lot of information yet to come. What will the other insulin makers do? It's possible by the time you're hearing this, things have already changed. So stay tuned to the website diabetes, connections, calm and follow on Social and we will keep you posted. Here is my interview with Andy Vicari, Lilly's us insulin brand leader.
Andy, thank you so much for jumping on the phone on what's got to be a very busy day. I appreciate you spending some time with me and my listeners.
Andy Vicari 3:15
Absolutely. Stacey. We're delighted with this announcement and happy to hop on a call with you.
Stacey Simms 3:19
The news broke earlier this morning. And you've already got calls coming in. We're only speaking about half an hour after the call center opened up. It sounds like it's already very busy.
Andy Vicari 3:30
Absolutely. And we expect that it will be a banner day when we had the press release a little more than a week ago with Dave bricks and some major publications. We had hit an all time high for the calls that we had received in the day and we hope to double that if we can we have it staffed and ready to go. And we want as many people to get us up as fast as possible.
Stacey Simms 3:51
You know, we spoke on that conference call in the middle of March about the insulin pricing issue and about many other things and when I am Then about lowering the price to $35, you had a lot of concerns about supply chain contracts, pbms wholesalers, what changed?
Andy Vicari 4:12
So we were in the works. So this solution was being prepared. But those back end dynamics are things that we have to work through. So while it would have been inappropriate for me, Stacey to promise it at that time, it was something that we've been moving towards for several weeks now all in response to the COVID-19 crisis. And I think, you know, as well as anybody, but for perhaps the listeners that aren't as attuned to some of the nuances of the drug supply chain, we have to work very closely with our partners and the last thing we would want to do is to create any sort of a panic or a rush, and then have this wonderful program that people can access or insulins. We're delighted that we are shipping out 100%. We have no back orders, we have no issues with our insulin, which is outstanding. So that's it timing is right for this program. But yes, to answer you directly when we did speak, this was something we had in the works. We're trying to get ready for market.
Stacey Simms 5:09
Great. I didn't mean to imply that it was as simple as me asking you on that call. But I am curious, you know, is this why it's a coupon? Because you, you have to work through the contracts that you already have. Is that why it's not just a blanket, hey, you go to the pharmacy, and it's automatic.
Andy Vicari 5:27
When I say contracts, or when I say on the back end, yes, we do have partners that adjudicate these claims. So for example, when anybody goes to the counter to be able to pick up their insulin, we want to make sure we had the things in place. So those that already have a card, that they are automatically reset to this $35 and it just takes time with some of our third party partners to make sure all of that is set. So that the experience when someone goes to the counter is as promised in the press release. So That's that's really some of the nuance behind it. But the conversations with yourself, the other advocacy groups, they are critically important. And I really love Stacey, something you had just recently wrote about. People speaking up and speaking out. We listen. I know, it's often a case where people are feeling like Big Pharma in general, isn't attuned to what's happening. But we've tried to lead from the front on the insulin issue as literally the heart of who we are and what we're really trying to do. So we always welcome those conversations.
Stacey Simms 6:32
You know, the press release doesn't mention an end date as I read it, and correct me if I'm wrong there. Is this indefinite after, you know, we get through COVID-19. What's the plan for that?
Andy Vicari 6:45
Yeah, you bet. important question. I think that's on everybody's mind. And what I can tell you is we don't have plans to change this program to turn it off. What we always do is constantly evaluate all of our Savings Programs and other reasons. forward as with legislation that's coming or perhaps going to be in place, it's important for us to constantly evaluate but right now, we have no plans to alter this program in any way. Post COVID-19. We hope we are hopeful for a lot of the legislation that is in the works. But we were I would say appropriately impatient, and not waiting for any of that to change and happen and we need to just get this done and get it done. Now,
Stacey Simms 7:26
talk to me if you could about Medicaid, Medicare, the government insurance programs, why are those excluded here.
Andy Vicari 7:34
For legal purposes we actually cannot they are not eligible for any coupons with any manufacturer on any product. We've taken other steps Stacy with our half priced insulin so that's a nice bro is the most recent that's out as of last year, and we plan to the middle of this month. are 7525 and quick pin Junior versions of those that are also at half price that helps people that are in those government programs get a much reduced insulin experience. Now we also have and have been running for some time through really cares for anyone that is in any of those federal or state programs, but is that 400% or below the federal poverty level. And to put that in perspective for people, that is somebody that makes a family of four would make 100, roughly $105,000. And for an individual, that is somebody that makes about $51,000. So anybody that at or below those levels, is eligible through really cares to apply for free insulin which, given the rates of unemployment and people filing for unemployment, I think that's a it's a well needed resource as well.
Stacey Simms 8:44
So would you recommend that if someone's not sure, someone who is over the age of 65, or was on another government program, another government insurance program, should they just call to find out what they're eligible for because I think a lot of people don't realize that they may be eligible for some discount.
Andy Vicari 9:01
Absolutely, you nailed it, Stacey, that is the most important thing. That's why we have chosen to implement this program the low insulin value program through our diabetes Solution Center. Because it is a little bit complicated out there. Sometimes when these healthcare professionals that answer those calls, they can help navigate that. And most of the time those people that call in that think they're not eligible, frankly, are end up being eligible for something. So yes, get them to that call center. And that is the best way for them to get the most affordable experience.
Stacey Simms 9:33
I don't know if you can answer this question, Andy. But I assume when you call into the center, that you know you give a lot of information. Does Lily collect that for purposes other than pricing? I mean, I guess there's there are some privacy concerns that I've heard a few people mentioned who have not necessarily called in, but who have said well what happens to that information that I'm sharing
Andy Vicari 9:56
it take as little information as possible. For example, but Give a real world example of somebody that's called in as of this morning and wants to access this $35 really influence value program. They'll take name, they'll take a callback number in case they get disconnected. And then for the quickest purposes, if they're willing to give an email address, they'll be able to email them this coupons so that they can go immediately to a pharmacy and start to use it. If they choose not to. We can send it over over mail. But the direct answer to the question is we don't use that information for anything other than to make sure people get the gift the discounts or insolent experience that we can give them.
Stacey Simms 10:38
I also had a question that came in early this morning. If it does end, can you commit to giving people enough notice? In other words, you know not, not the next morning we wake up and say sorry, it ended last night at midnight.
Andy Vicari 10:54
Sure, understood. So terms and conditions on all discount programs across manufacture. They have to be renewed each year. So this program, which again, as you and I talked about, we don't have plans to turn off in January, one of 2021, people will need to access a new card, so that that's no different than than any other program. So in that timeframe, they would know in calling into the call center, we'll be continuing that or not. But like I said, the most important thing we want listeners to take away from this is, we don't have plans to change this. We always evaluate the external environment as legislation changes. But we know this is an absolutely much needed program, especially since it covers those without insurance.
Stacey Simms 11:38
And if that's really interesting, you know, to realize that it will go at least through January and then further as you said, You sound like you're just going to renew it and move forward. You've been in the insulin business and in the pricing arena for a very long time. I'm sure you've heard a lot of angry comments and a lot of concerns why people are going To ask Andy and I'll just ask it for them. Why did it take so long? If this can go on for a long time, I assume Lilly thinks it can stay in business. So why did it take so long?
Andy Vicari 12:10
You know, really, for us it's been this isn't a new behavior, Stacy. What I mean by that is we've been looking for different ways, within the rules of the healthcare system today, to ensure that we can get the direct savings to people with the people that are actually filling their prescriptions and not go to some other third party within the drug supply chain. That's why things like standing up the diabetes Solution Center and insulin lice pro launch was so important. It's why we've continued on the back end, which we will continue with our programs where even if somebody doesn't know about this program, yet, they'll still get bought down to $95 or less. But if they have a card that they're already accessing, it will automatically get them down to $35. So the direct answer to your question is we've been at this for a while and we've been coming You need to find different ways. And the last one of the last gaps we saw Stacey was those that have no insurance. And this experience is one that we'll be able to, to ensure that those people that are paying cash or paying full retail price, get the maximum savings. So it's a it's a way for us to ensure that it happens at the right time, which is right now, given everything with COVID-19. And we felt like our other programs that were in place, we're doing an adequate job up until recently, as you can see from all the unemployment numbers,
Stacey Simms 13:34
and I'm sorry, that went by quickly pardon my ignorance when you mentioned $95 automatically. I'm sorry, could you repeat? That was
Andy Vicari 13:42
sure we'd been running for a couple of years now. programs in the background through a third party called relay health, where it automatically a fewer I go to the counter and say our bill was we're on a commercial insurance and our bill was $150 Unbeknownst to the person at the counter, they would never know that we'll lose doing this. They don't need to sign up for anything. They don't need to activate anything, it just automatically ensures that they pay, right around $100 or less, really $95 is what we shoot for. So that has been happening for quite some time. And it's something that we're certainly proud of to try to give a reasonable experience for people given COVID-19 right now, go ahead.
Stacey Simms 14:27
I was just gonna say, is that something that since the person buying it doesn't know, do they have to ask their pharmacist to run it through? Does the pharmacist know about it?
Andy Vicari 14:35
They do not. So there's pharmacies that participate with relay health and for those pharmacies that do, it just automatically happens. It's Think of it this way, Stacey, if you were I don't know where your favorite grocery store is. But as a customer, they're probably scan your card and you get some automatic savings. It is exactly like that. The difference is you don't need to do anything as the consumer. It just happens in the back end in our actions with really help In the pharmacy, so, for any pharmacy that participates with really help, that automatically happens unbeknownst to the consumer.
Stacey Simms 15:07
All right, let me ask you a pie in the sky issue. do you envision a time with the complicated health system that I know we have in the United States? I know this is not all on Lilly. But do you envision a time where instead of calling to get a coupon instead of thinking Do I really health and you know, scanning my my quote my Vic card at Harris Teeter, that's the grocery store I use? You know, do you envision a time where insulin is just priced lower and we just go get what we need?
Andy Vicari 15:35
I do think there'll be legislation that will happen. I think it's it's less about the insulin. I think it's about chronic medications overall. And I think that is to us, the most important thing is insulin easily the front and center conversation around it. Absolutely. Until that day, we're going to continue to push and find ways but I do foresee with chronic medications from legislation standpoint, I think one of the ones one of the things that I'm most excited about is what Center for Medicaid and Medicare has done in their Innovation Group. All three insulin manufacturers have announced that we're partnering with them as of January 2021, to make sure that those health plans that participate, have their their customers pay no more than $35 a month for those in Part D, which is incredibly important. If we rewind to part of our conversation, we talked about the legality and the rules. Right now those people aren't eligible for some of these savings and coupons. But that is a program that would ensure that this $35 a month is for not just commercial, uninsured. Also the Part D That to me is a significant step.
Stacey Simms 16:46
Well, Andy, I really appreciate you jumping on when we spoke a couple of weeks ago, you know, we were talking about how a crisis is a time to define what companies are all about. I really appreciate this and I wanted to say thank you to Lily. It's going to help a lot Have people it's a it's a great opportunity to stand up. So we blessed you when it's appropriate. But kudos, and thank you for doing this. And I hope it does continue. But thanks for spending some time with me this morning. I appreciate it,
Unknown Speaker 17:13
Stacey, and thank you for what you do for advocacy and helping get the word out. So we can't do it without you.
Stacey Simms 17:23
Again, all of the information that we spoke about is on the website at the episode homepage, diabetes, dash connections.com. There's a transcript of that interview as well. If you want to share that with people who would prefer to read rather than Listen, I get it.
And as I said before the interview, I do think things are going to change more information is going to come out that sort of thing. And we'll see what the other insulin makers do as well. They usually do follow each other when it comes to price increases. So we'll see what happens now that Lily is offering this coupon and this program indefinitely. It sounds like right.
Look, I know there's already a lot of criticism online about how this doesn't go far enough. And I get it. And I've already this morning been called a shill for Lilly. I do think there is a way to have polite conversations about this and to keep pushing.
So if you have questions, I'm gonna have an opportunity to talk to them again, I know, not everybody is fortunate enough to do that to speak directly to these folks. But I want to bring your questions and your concerns to them. So keep those questions coming. You can always reach me Stacy at diabetes, connections calm. We'll have a big discussion about this, I'm sure in the Facebook group diabetes connections, the group and we will keep it going. But I'm telling you, this didn't happen in a vacuum. This happened because people like you raised your voices, tweeted, spoke out, talk to your state representatives. I really do think I've said this for many years. The pressure from the state legislatures is what is going to change the insulin pricing problem in this country. The drug pricing, the medical pricing In this country, it's going to come from the States. And we're already seeing that happen. I don't think that this movement alone this change of price alone is going to stop what's happening in state legislatures because it doesn't cover everybody and you do need a coupon and there's a lot more that needs to be done. And as I'm taping, it's only Lily it's not noovlog. It's not novo, Nordisk it's not Sanofi. So the work is far from over, but this is a big, big step.
Okay. In terms of the show, our next episode, which would have been the regular episode for today is going to come out on Thursday. If news stops breaking, we'll get back to the regular schedule, which is a regular episode every Tuesday. However, I am more than happy to continue to bring this information to you. And I think it's more than the information right because you can read a press release. But to me, I like to hear the voice of the people behind the stories. I really feel like you get a lot of nuance, a lot of information and a lot of fetal if that makes sense. Thanks for joining me. Let me know what you think. Keep your questions coming. Let's keep pushing. I'm Stacey Simms. I'll see you back here for our next episode.
Unknown Speaker 20:08
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