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HELP WITH YOUR DIABETES PRESCRIPTION AND INSULIN COSTS

All people with T1D should have affordable access to insulin. While sharing the
resources below that can help with costs, JDRF is also fighting for changes from
manufacturers, health plans, employers, and the government to make insulin more
affordable. Learn more here. 

Prescription costs for drugs to treat type 1 diabetes (T1D) can make up a large
percentage of what you pay each year for healthcare. There are a few ways you
can lower your prescription and insulin costs: through state and nonprofit
programs; diabetes patient assistance programs offered by pharmaceutical
companies; medication discount cards; and prescription alternatives such as
biosimilar insulin.


IN THIS SECTION WE’LL DISCUSS

 * Nonprofit Patient Assistance Programs For People With Type 1 Diabetes
 * Patient Assistance Programs (PAPs)
 * State-Based Patient Assistant Programs for People with Type 1 Diabetes

“I honestly think I got the most help from calling the manufacturer’s assistance
programs. They have a really good grip on how their products are covered, and
they gave me great advice on how to lower my costs.”
—T1D patient, WY


NONPROFIT PATIENT ASSISTANCE PROGRAMS FOR TYPE 1 DIABETES

There are a number of patient and insulin assistance programs available to help
with the costs of your medication, many of them run by nonprofit organizations.
They include the following:

 * GetInsulin.org. JDRF is pleased to partner with Beyond Type 1 and dozens of
   other organizations on GetInsulin.org, a new tool that will help meet the
   immediate need for people in the United States to access insulin while we
   continue working on long-term solutions to address insulin affordability.
   Anyone in need of help can visit GetInsulin.org for a customized action plan,
   available in English and Spanish.
 * Partnership for Prescription Assistance is a program sponsored by
   pharmaceutical companies, doctors, patient advocacy organizations and civic
   groups that helps low-income, uninsured patients get free or low-cost
   brand-name medications.
 * NeedyMeds is a nonprofit organization that maintains an extensive database of
   patient assistance programs, state assistance, medication discount programs
   and free or low-cost medical care. You can search its database for free. The
   site also has information on thousands of programs to help consumers through
   the application process.
 * RxAssist is an online database of pharmaceutical company programs that
   provide free or affordable medicines and co-pay assistance.
 * RxHope is a web-based resource where you can search by medication to locate
   assistance programs. It also offers help with the application process.
 * RxOutreach is a nonprofit mail-order pharmacy for uninsured or underinsured
   people.
 * The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
   also has a publication called “Financial Help for Diabetes Care,” which
   offers information about resources that may help with medical expenses of a
   person with diabetes. You can view this publication online or order copies
   from the National Diabetes Information Clearinghouse at 1-800-860-8747.


PHARMACEUTICAL COMPANY PATIENT ASSISTANCE PROGRAMS

You may be able to get help with the costs of insulin and medication through
drug assistance programs from pharmaceutical companies, known as patient
assistance programs (PAP). Each program has its own eligibility requirements for
people with type 1 diabetes, so it’s important to check those details. Here are
a few programs offering assistance for diabetes medications:

 * The Johnson & Johnson Patient Assistance Program
 * The Lilly Cares Foundation Patient Assistance Program
 * The Novo Nordisk Diabetes Patient Assistance Program
 * The Sanofi Patient Assistance Program
 * Leading pharmaceutical companies have also created the Together Rx Access
   Card to help people without other prescription drug insurance coverage gain
   access to savings on prescription products. The Together Rx Access Card
   offers 25 to 40 percent off brand-name prescription medications at pharmacies
   nationwide. To learn more about the card, visit the Together Rx Access Card
   website or call 1-800-444-4106.

You can also find a program by searching on the medication name here.

If you need assistance with your pump supplies or CGM, directly contact the
manufacturer via their customer service number.

 * Medtronic: 1-800-646-4633
 * Tandem: 1-877-801-6901, option 3
 * Insulet: 1-800-591-3455
 * Dexcom at 1-888-738-3646
 * Abbott Diabetes Care: 1-855-632-8658


PHARMACEUTICAL COMPANY CO-PAY COUPONS

Co-pay coupon cards can be used by anyone, regardless of income, to reduce your
out of pocket costs at the pharmacy. They often can be used for one or two years
before you must re-sign up. One catch to using these coupons is that to the
costs they cover may not count toward your deductible or out-of-pocket maximum.
Also, you may not use these coupons if you have Medicare, Medicaid, Tricare or
other government health insurance. Read the details for each coupon to determine
if the coupon will work for your situation.

You can find more information about each of the coupons here:

 * Novo Nordisk
 * Eli Lilly
 * Sanofi
 * Xeris (Gvoke)


STATE-BASED PATIENT ASSISTANT PROGRAMS FOR PEOPLE WITH TYPE 1 DIABETES

Many states also offer medication assistance programs for people with chronic
conditions like type 1 diabetes. These programs vary greatly by state, so make
sure to check the program criteria. Search what’s available in your state here.


OTHER OPTIONS FOR LOW COST INSULIN


PRIVATE LABEL INSULIN

A number of national drug store and pharmacy chains also have their own
prescription programs to help customers save money on certain medications.
Stores with these programs include Costco, CVS, Kmart, Rite Aid, Target,
Walmart, and others. Speak with your pharmacist at any of these stores for
details.

Walmart offers an insulin aspart, manufactured by Novo Nordisk, called ReliOn
Novolog in both vials and Flex Pens. ReliOn Novolog will be offered for $72.88
per vial and $85.88 per five-pen box of FlexPens. For more information see
Walmart’s announcement. If interested in ReliOn Novolog, consult your provider
and locate a Walmart pharmacy near you.


NON-BRANDED INSULINS

Eli Lilly and Company’s Insulin Lispro Injection, 100 units/mL, which is a
non-branded version of Humalog®, will have a 70 percent lower list price than
Humalog U-100 starting January 1, 2022. Insulin Lispro is identical to Humalog
in composition, but comes in a different bottle. Insulin Lispro Injection can be
ordered through all U.S. retail pharmacies. Monthly prescriptions for all Lilly
insulins – including Insulin Lispro Injection – remain available for $35 through
the Lilly Insulin Value Program and the Medicare Part D Senior Savings Model. 

Novo Nordisk offers non-branded versions of NovoLog and NovoLog Mix called
Insulin Aspart and Insulin Aspart Mix, respectively, at a lower list price than
NovLog and NovoLog Mix. 


BIOSIMILAR INTERCHANGEABLE INSULINS

An interchangeable biosimilar insulin has recently been approved by the FDA. A
biosimilar product is highly similar to, and has no clinically meaningful
differences in safety, purity, and potency (safety and effectiveness) from an
existing FDA-approved reference product. An interchangeable biosimilar  can be
substituted by the pharmacist with its reference product.  The only currently
available interchangeable biosimilar insulin is called Semglee(insulin
glargine-yfgn). The reference product that Semglee is biosimilar to and
interchangeable with is Lantus®. Semglee has a lower list price than Lantus.


COMMUNITY HEALTH CENTERS

Community Health Centers are health care providers that provide medical care for
anyone, with or without insurance and with a sliding scale payment option (your
cost to use the center is tied to your income).  A list of these health centers
can be found here: https://findahealthcenter.hrsa.gov.  They can help you access
insulin or other prescriptions at a reduced cost.


ASK YOUR PHYSICIAN FOR SAMPLES

If you are struggling to afford insulin, be sure to tell your health care
provider. Your primary care provider or endocrinologist may have insulin samples
available in their office.  They also can help you find ways to reduce your
costs by writing a larger quantity prescription, changing brands or formulas or
documenting your medical needs for other assistance programs.


OLDER FORMULATIONS OF INSULIN

If you are in immediate need of insulin and have no health insurance coverage
and limited funds, it is possible to obtain very affordable older types of
insulin over the counter from Walmart or Sam’s Club.  This insulin is sold under
the ReliOn name and costs $25 for a 10mL vial.  It works differently than newer
insulins, so you will need to learn how to dose it correctly.

 

 

JDRF maintains a forum where insurance issues can be discussed.
If you have questions for the community, you can post them here!

Is this resource helpful? Did we miss something? Let us know!



 
 * T1D Health Insurance Guide
   * Choosing a Plan
   * Help With Costs
   * When You Lose Your Coverage
   * Denials and Appeals
   * Prior Authorizations
   * Applying for an Exception
   * Switching Treatments
   * Insulin, CGMs, Pumps
   * Working With Employers
   * Medicare
   * Insurance Terms

Also of Interest:
 * Novo Nordisk Offers 90 Days of Free Insulin to...
 * When You Lose Your Coverage
 * How to Lower the Cost of T1D

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