Focus On Access: Mike Mason, Vice President of Lilly Diabetes

Editor’s Notes: This piece is a part of Focus On Access, a content series sharing resources and perspectives on insulin pricing in the United States. Explore the full series here.

People who take insulin require consistently affordable and predictable sources of insulin at all times. If you or a loved one are struggling to afford or access insulin, click here.

What is your position at Lilly Diabetes?

I am senior vice president of our connected care and insulins business.

What is Lilly doing to address insulin affordability and access in the United States?

We’re doing many things—and we’re determined to build upon this work until everyone is getting the help they need.

One important program is the Lilly Diabetes Solution Center, which we opened in August. We use live representatives to connect people with the best solutions available to them—including point-of-sale savings, information about obtaining insulin at free clinics and help for people who have an immediate need for insulin. Our solutions are customizable and based on the personal circumstances of people who dial in, so we encourage people using any Lilly insulin to call the Solution Center to learn whether there are lower-cost options for them. (Contact information is 833.808.1234 Monday through Friday 9 a.m. – 8 p.m. ET)

The majority of people can access insulin for well below the list price. As of today, 95 percent of people pay less than $100 a month at the pharmacy for Humalog, our most commonly used insulin. But we know some people are still paying too much.

Uninsured patients are people who are most exposed by the current healthcare system. In fact, we believe there are about 1,600 people without insurance who have not yet utilized our Solution Center, so we continue looking for ways to make them aware of their options. We have programs that significantly reduce the cost of insulin for the uninsured, so no one without insurance needs to pay anywhere near full list price for our insulins.

List prices of insulin have doubled (across the board) in the United States since 2012. Can you give us any insight into the factors that determine the list price of insulin that account for these increases?

List prices have gone up for several reasons: from the evolution of the U.S. health reimbursement system to the steep investment that goes into keeping our manufacturing facilities state-of-the-art.

Our insulin manufacturing facility in Indianapolis alone is more than 1 million square feet—the equivalent of 18 football fields—and manufacturing insulin requires deep technical expertise and a significant, ongoing financial commitment. Lilly has invested more than $1.2 billion since 2012 to expand our insulin manufacturing plant in response to the growing diabetes epidemic and increased demand for insulin worldwide.

We also continue to fund the search for more breakthrough medicines. Over the last six years, Lilly has invested more than $4 billion on research and development related to diabetes, and well more than $25 billion on R&D overall.

What do you see as the biggest problem contributing to the insulin access problem in the United States?

We have a system with many tiers, and no one entity has created this issue. As the system has evolved, gaps have arose.

We’ve had discussions with numerous stakeholders and we know the uninsured, people in high-deductible health plans, and those in the coverage gap of Medicare Part D are exposed in the current system. High-deductible health plans have grown significantly over the last 10 years, resulting in higher out-of-pocket costs for patients—typically thousands of dollars—for health care treatments.

Does Lilly Diabetes have a perspective on the #Insulin4all movement?

This issue affects people in many different ways. We appreciate people engaging and having their voices heard. Everyone is focused on helping people with diabetes access insulin affordably.

What one change to the current system in the United States do you feel would be the most impactful in improving access to insulin in the short term?

In the short-term, employers can help people living with diabetes and other chronic conditions. Lilly’s employee health plan passes through prescription drug rebates at the point-of-sale and exempts insulin and other chronic disease medicines from the deductibles of our health plans. This design could be adopted by employers across the country.

We also support the Chronic Disease Management Act of 2018, which would allow high-deductible health plans to provide first dollar coverage for healthcare services and medicines for various chronic conditions. The Congressional Diabetes Caucus also has recommended legislative action that would cap out-of-pocket costs.

What long-term solution is Lilly Diabetes most hopeful about?

All of the solutions that we’ve discussed could meaningfully help people living with diabetes.

Can you describe the role Lilly plays in determining insulin pricing in international markets and why the list price varies drastically from country to country?

Drug prices vary from country to country because each values medicine and innovation differently, and they all balance competing demands for limited resources. This leads to price variations across markets. Lilly’s prices are based on a variety of criteria—primarily the value of the product within a country, including patient benefits, its place in the national healthcare system, patterns of disease burden, willingness and ability to pay and national socio-economic indicators.

Does Lilly Diabetes have a reaction to U.S. Residents traveling abroad to purchase insulin because of lower international list prices?

If someone is using Lilly insulin, we believe our Solution Center is a better, more convenient way to find lower-cost options. We encourage this route versus purchasing insulin outside the U.S., where there is no FDA oversight. Pharmacies in other countries can appear safe and less expensive but may obtain medicine from countries where quality standards are more lax and counterfeiting is widespread.

Can you share any metrics on the use and impact of Lilly’s patient assistance programs?

We are helping more than 10,000 people each month significantly reduce the amount they pay for Lilly insulin through our cost-savings programs, including through the Lilly Diabetes Solution Center. Beyond that, Lilly has donated more than 5.4 million insulin vials and pens to charitable organizations for people in need across the U.S. over the last five years.

We can help more people if they call the helpline. Many of our solutions are new, and our representatives are trained to help people identify the best solution to reduce their cost at the pharmacy.

Lilly recently announced the introduction of a lower-priced version of Humalog. Can you explain the reasoning and timing behind this decision? Why not simply lower the list-price of Humalog?

Lilly’s Insulin Lispro helps move the system toward a more sustainable model. The significant rebates we pay on insulins do not directly benefit all patients.

We want everyone who needs insulin to be able to afford it. Approximately 95 percent of people who use Humalog pay less than $100 for their monthly prescription at the pharmacy, but for people who face the highest costs—such as those with high deductible insurance plans, the uninsured, or people in the coverage gap of Medicare Part D—this new option makes insulin more affordable without disrupting the system for people who face lower costs with co-pay insurance plans.

Focus on Access Editorial Disclosure: The position presented above is solely that of the author. Other than fact-checking and formatting, Beyond Type 1 has not edited the content of this post. Additionally, at the time of publication, Beyond Type 1 has an active partnership with Eli Lilly specifically focused on glucagon and severe hypoglycemia; as part of that partnership, Eli Lilly, under the Glucagon brand name, is a Founding Partner of Beyond Type 2.