How to Afford Insulin: Cost Help for Diabetes Patients

Why does insulin cost so much — and has anything changed?

Insulin prices in the US were historically among the highest in the world due to a complex system of manufacturer list prices and pharmacy benefit manager rebates. That has been changing:

• The Inflation Reduction Act (2022) capped Medicare Part D insulin costs at $35 per month per insulin for Medicare beneficiaries, effective January 1, 2023 1Ref 1U.S. Centers for Medicare & Medicaid Services (2023).The Inflation Reduction Act Lowers Health Care Costs for Millions of Americans.$35/month Medicare Part D insulin cap effective January 1, 2023 under the Inflation Reduction Act.
• Most major insulin manufacturers (Eli Lilly, Novo Nordisk, Sanofi) voluntarily capped out-of-pocket costs at $35/month for commercially insured and uninsured patients through their own programs.
• Several states have passed their own insulin cost caps for state-regulated insurance plans.
• Biosimilar insulins (Rezvoglar, Semglee, and others) have brought list prices significantly lower, creating more competitive options .

What insulin is available over the counter without a prescription?

Certain older human insulins — Regular and NPH — have long been available over the counter at major pharmacies (Walmart sells them under the ReliOn brand for around $25 per vial). These are effective insulins but work differently from the analog insulins most modern diabetes management is based on (glargine, detemir, lispro, aspart, degludec).

Switching insulin types without medical guidance can affect blood sugar control significantly. If cost is driving a switch, discuss it with a clinician first — there may be a way to get the analog insulin you are already on for less, or a planned transition can be done safely.

Manufacturer patient assistance programs

All three major insulin manufacturers have programs for patients who cannot afford their insulin:

• Eli Lilly — Insulin Value Program: $35/month cap for Lilly insulins (Humalog, Basaglar, Humulin) for uninsured and commercially insured patients. lillyinsulin.com
• Novo Nordisk — Patient Assistance Program: Free or reduced-cost insulin for qualifying low-income uninsured patients. novonordisk-us.com/patients
• Sanofi — Insulins Valyou Savings Program: Significant discounts for commercially insured and uninsured patients on Lantus, Toujeo, Admelog. sanofipatientconnection.com

Eligibility criteria vary. These programs are worth applying to regardless of insurance status .

Other programs and resources

GoodRx and similar discount platforms Free discount cards and apps that negotiate lower pharmacy prices. GoodRx can sometimes bring insulin costs below $50 to $100 for a 90-day supply, depending on the product and pharmacy.

Community health centers (FQHCs) Sliding-scale primary care that includes diabetes management. They often have access to 340B pricing — federally negotiated drug prices far below retail. Find one at findahealthcenter.hrsa.gov.

State programs Several states (Colorado, California, and others) have additional assistance programs or insulin-specific caps for state-regulated plans. Check your state health department's website.

Biosimilars and interchangeable insulins The FDA has approved multiple biosimilar and interchangeable insulin products. Ask your pharmacist whether a lower-cost interchangeable version of your prescribed insulin is available .

How can a Gale clinician help?

Affording insulin is partly a logistics problem and partly a clinical one. A Gale primary care clinician can:

• Review your current insulin regimen and whether a different (lower-cost) insulin might work equally well for you 2Ref 2American Diabetes Association Professional Practice Committee (2024).Standards of Care in Diabetes—2024.Insulin selection and regimen optimization as a component of diabetes management; cost is an explicit consideration in the ADA framework
• Write prescriptions in the format best suited to the assistance program you are applying for
• Help you apply for manufacturer programs
• Monitor your diabetes management if a transition to a different insulin is needed
• Coordinate with a pharmacist or endocrinologist for complex cases

If you are rationing insulin — taking less than prescribed to make it last — tell your clinician. This is a serious safety concern and there are almost always alternatives to explore first.