Diabetes
Sonya Collins
Early last summer, Walmart announced the launch of a new private-brand, cash-pay analog insulin, made by drug manufacturer Novo Nordisk. Sold under Walmart’s private ReliOn label, vials go for $72.88 each and FlexPens for $85.88 each. Walmart calculates that the products will save customers between 58% and 75% of the cash price for branded analog insulin products, which translates to savings of up to $101 per branded vial or $251 per package of branded FlexPens. But, for many who struggle with the day-to-day costs of living with diabetes, these brands may still be tough to afford. Other pharmacies or drug-maker patient assistance programs may offer more support to cash-strapped patients.
A viable option for a small group of patients
While Walmart’s new private label offers a deep discount on retail prices, the program may only help a small subset of cash-paying patients.
“This will help the few patients who have no health insurance and can’t get insulin cheaper through patient assistance programs,” said Robert Popovian, PharmD, a pharmaceutical economist and chief science policy officer for the Global Healthy Living Foundation.
People who carry high-deductible health insurance may also save when they buy the Walmart insulin. And, occasionally, patients need an emergency vial of insulin when it’s too early for their insurance to cover a refill; for example, when they forget to bring insulin on a trip. “They are going to have to pay cash, and they need it fast, so they could go to Walmart for this insulin,” said Diana Isaacs, PharmD, BCPS, BC-ADM, CDE, a diabetes educator at the Cleveland Clinic Endocrinology & Metabolism Institute.
But, she adds, for those who qualify for them, patient assistance programs such as Sanofi’s $99-per-month insulin program most likely still beat Walmart’s offer.
Plenty of room for competition
Because the Walmart–Novo Nordisk insulin stands to be the best bet for only a sliver of the diabetes population, other pharmacies can certainly continue to compete in this market. They can carry biosimilars at competitive prices and can also stock Lily’s generic lispro and Novo Nordisk’s generic aspart.
“Pharmacists can make a direct substitution with these because they are true generics,” Isaacs said. “It’s half the price of the brand, around $150 a month.”
A too-small step in the right direction
More than help patients today, Walmart’s new product may help many patients in the long run as the new lower price shines a light on the ills of insulin pricing in the United States.
“We wouldn’t need these gimmicky private label deals—except for the uninsured and people with high deductibles—if we didn’t make patients pay inflated drug prices,” Popovian said. “They play with these numbers and make people think that they are doing something good, but they know what the breaking point is where they can make themselves look good and still make a profit.”
The pharmaceutical economist holds that the only fair and affordable insulin pricing model would be to charge patients based on the net price, not the retail price. “It’s such a critical drug. That’s why a lot of states have started looking into the price of insulin and have debated legislation to cap patients’ out-of-pocket costs.”
At the very least, new programs like the Walmart–Novo Nordisk deal raise important questions, Isaacs said. “While it’s not groundbreaking, it’s always good to see the price go down,” she said. “It makes people ask, ‘If you can sell this ReliOn for so much cheaper, why are all the other insulins so expensive?”