New York Attorney General Secures Agreement to Cap Insulin Prices for Uninsured Residents

Summary:

New York Attorney General Letitia James secured an agreement with insulin manufacturers Eli Lilly and Sanofi-Aventis U.S. LLC to cap the price of insulin at $35 per monthly prescription for uninsured New Yorkers for five years. The agreement was reached after an investigation by the Attorney General’s Office 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.

Under the agreement, any uninsured New Yorker who uses Lilly or Sanofi insulin products will not be charged more than $35 for a monthly supply of insulin for the next five years. Both companies also committed to offering free insulin for the neediest patients.

The agreement is a major victory for public health and social justice, and it is a model for other states to follow. Insulin is a lifesaving medication, and no one should have to choose between their health and putting food on the table.

Following is the Official Press Release:

Attorney General James Secures Agreement with Insulin
Manufacturers to Cap Insulin Prices for Uninsured New Yorkers  

Eli Lilly and Sanofi-Aventis U.S. LLC Agree to Cap Insulin Prices at
$35 Per Monthly Prescription for Uninsured New Yorkers for Five Years 

NEW YORK – New York Attorney General Letitia James today secured agreements from the nation’s largest insulin manufacturers, Eli Lilly and Company (Lilly), and Sanofi-Aventis U.S. LLC (Sanofi), to cap the price of insulin at $35 per monthly prescription for uninsured New Yorkers for five years. 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. Under today’s agreements, any uninsured New Yorker who uses Lilly or Sanofi insulin products will not be charged more than $35 for a monthly supply of insulin for the next five years, and both companies also committed to offering free insulin for the neediest patients.

“Lifesaving medication should be affordable and accessible for all New Yorkers regardless of their income or insurance status,” said Attorney General James. “Today, uninsured New Yorkers who rely on insulin to manage their diabetes can breathe a sigh of relief that they no longer have to choose between their health or putting food on the table. I will always use the powers of my office to protect vulnerable New Yorkers, and to ensure no company takes advantage of them.” 

Over the past two decades, the list prices for insulin have increased dramatically. From 2002 to 2013, the average list prices for insulin products from all manufacturers nearly tripled. For a person with Type 1 diabetes, annual spending on insulin averaged $2,864 in 2012, and that spending increased to an average of $5,705 in 2016. 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. 

More than 10 percent 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 percent more likely to have diabetes. In fact, more than 16 percent of New York adults with diabetes have an annual household income of less than $25,000, while only six percent have an annual household income of more than $50,000. 

As part of these agreements, Lilly and Sanofi have committed to offering affordable programs that ensure that no patient walks away from a pharmacy empty-handed because they could not afford their insulin. Both Lilly and Sanofi have agreed to implement a streamlined process at the pharmacy counter that would allow pharmacies to automatically advise cash-paying consumers of their ability to fill their monthly prescription for $35, before leaving the pharmacy counter.  

In addition to the $35 monthly cap for any uninsured New Yorker, Lilly has also agreed to continue working with national relief agencies to identify high-need geographical locations throughout New York and to offer insulin products free of charge, through national relief agencies, to more eligible non-profit clinics in those locations. Those clinics can then offer insulin products for free in those areas that are the most in need. Sanofi has also agreed to offer free insulin to the neediest consumers who meet income thresholds tied to the federal poverty line.  

“Access to affordable insulin is a matter of life and death, and no one should have to choose between putting food on the table or buying medication they need to survive,” said Westchester County Executive George Latimer. “I am proud that New York is taking a bold step forward in making insulin more accessible and affordable for our residents, and I commend Attorney General Letitia James for reaching this landmark agreement. This is a major victory for public health and social justice, and it is my hope that other states will follow New York’s lead in ensuring that all Americans have access to the medications they need to live healthy lives.”

“Insulin is critical for those who need it to manage their diabetes,” said Assemblymember Amy Paulin. “The high cost of insulin, however, can impact adherence to an insulin regimen. In turn, non-adherence can have quality-of-life impacts as well as serious health consequences. I commend Attorney General Letitia James for reaching an agreement with insulin manufacturers to cap insulin prices for uninsured New Yorkers. No one should have to make a tradeoff between their spending on basic living necessities or their health.”

“New Yorkers should never have to beg and borrow to obtain lifesaving medications,” said Assemblymember Linda B. Rosenthal. “However, for far too long, big pharmaceutical companies charged hardworking New Yorkers a fortune for treatment, leaving some to forego much-needed care. That devastating power imbalance ends today. Thanks to Attorney General James, uninsured New Yorkers will now be able to access insulin at a reasonable cost, leveling the playing field for all who rely on this critical medication.”

“I am thrilled that the Attorney General has taken action to proactively ensure access to lifesaving medication for thousands of New Yorkers,” said Assemblymember Phara Forrest. “Health should never be predicated on someone’s ability to pay and pharmaceutical companies have been callously preying upon diabetics for far too long. I look forward to continuing to work to increase access to insulin for all New Yorkers by passing my bill A.4141 and I hope the Attorney General will join me in that effort.” 

This investigation 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 and Protection 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.