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Attorney General James secures agreement with insulin maker Novo Nordisk to cap insulin prices for uninsured New Yorkers


Mon, Sep 11th 2023 05:35 pm

Novo Nordisk agrees to cap insulin price at $35 per monthly prescription for uninsured New Yorkers for 5 years and streamline process for patients at pharmacy counter

√ James previously secured $35 monthly cap from Eli Lilly and Sanofi-Aventis U.S. LLC

New York Attorney General Letitia James on Friday secured an agreement with one of the nation’s largest insulin manufacturers, Novo Nordisk Inc. (Novo Nordisk), to cap the price of insulin at $35 per monthly prescription for uninsured New Yorkers for five years. The agreement also requires Novo Nordisk to implement a program with pharmacies to let uninsured patients know before they pay that they are eligible for the insulin cap.

This agreement follows earlier agreements with two other large insulin makers, Eli Lilly and Sanofi, to cap insulin prices at $35 a month for uninsured New Yorkers.

“New Yorkers who rely on lifesaving medication like insulin should not have to ration their doses or forgo taking their medicine altogether because they cannot afford it,” James said. “(This) agreement will mean that uninsured New Yorkers do not have to choose between taking their insulin and putting food on the table. I will always use the powers of my office to help protect vulnerable New Yorkers, and to ensure no company takes advantage of them.”

The AG’s team said, “More than 10% of New Yorkers have diabetes, and it is estimated that 464,000 of them rely on insulin every day. New Yorkers who live in the state’s poorest neighborhoods are 70% more likely to have diabetes. In fact, more than 16% of New York adults with diabetes have an annual household income of less than $25,000. An investigation by the Office of the Attorney General (OAG) found that the list prices set by insulin manufacturers for patients resulted in significant out-of-pocket costs for certain insulin users, causing some to ration their insulin or forgo it altogether. Over the past two decades, the list prices for insulin have increased dramatically, with prices from all manufacturers nearly tripling from 2002 to 2013. For a person with Type 1 diabetes, annual spending on insulin averaged $2,864 in 2012, and by 2016, nearly doubled to an average of $5,705. These dramatic cost increases were not driven by insulin manufacturing costs, which by one estimate would be no more than $133 per person per year.”

As a result of this agreement, Novo Nordisk is required to cap the price of its insulin products, including Novolog, Novolin and Fisap, at $35 per monthly prescription. Additionally, Novo Nordisk is required to implement a streamlined process at the pharmacy counter that would allow pharmacies to automatically advise cash-paying customers of their ability to fill their monthly prescription for $35 before leaving the pharmacy counter. To do this, Novo Nordisk must contract with a third-party messaging company that would immediately notify a pharmacy or pharmacist that an uninsured patient is eligible for the $35 monthly cap when they are filling their prescription.

In addition to the $35 monthly cap for any uninsured New Yorker, Novo Nordisk has also agreed to continue offering free insulin to the neediest consumers who meet income thresholds tied to the federal poverty line. Novo Nordisk has also agreed to continue offering its immediate supply program, through which it offers an immediate, free supply of insulin to consumers at risk of rationing due to financial hardship. For uninsured New Yorkers below the federal poverty level who do not seek reimbursement from any federal or state health care program, Novo Nordisk will also offer insulin at no cost.

More information on Novo Nordisk’s affordability programs can be found here

This case was handled by Assistant Attorney General Kate Matuschak of the consumer frauds and protection bureau under the supervision of Deputy Bureau Chief Laura J. Levine and Bureau Chief Jane M. Azia; Deputy Bureau Chief Amy McFarlane of the antitrust bureau; and Special Counsel Steven J. Glassman of the economic justice division. The consumer frauds bureau and the antitrust bureau are part of the division of economic justice, which is led by Chief Deputy Attorney General Chris D’Angelo and overseen by First Deputy Attorney General Jennifer Levy.

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