Walmart just announced a new low-priced insulin for patients with diabetes.

Is this good news?

Yes, for some patients. Walmart already offers an older formulation of human insulin, ReliOn Novolin, for $25 per vial. Adding a low-cost rapid-acting analog insulin — ReliOn Novolog — to the Walmart ReliOn brand should help patients who are better treated with this modern analog insulin and who would otherwise be paying the full list price.

Yet, this lower cost option is not enough to fully address the issue of insulin affordability and it highlights the systemic problems we face in the U.S. regarding the high costs of needed prescription drugs.

This is still too high a price for a needed drug. While Walmart’s ReliOn Novolog is priced at a significant savings off the list price — $73 per 10 mL vial compared to $289 for branded NovoLog — this price is still high compared to the rest of the world. It is many times higher than the $6 to $13 per vial consumers pay for rapid-acting analog insulin in OECD (Organisation for Economic Co-operation and Development) countries outside the U.S. It is also significantly higher than the $6 to $7 per 10 mL vial studies have estimated it costs to manufacture this type of insulin and bring it to market. A typical patient using two vials of rapid-acting insulin per month will spend $1,749 per year for Walmart’s ReliOn Novolog. While much less than the $6,945 full list price, this is still a very high price for an essential drug.

Comprehensive insulin-dependent diabetes treatment is still unaffordable for many. Access to insulin can be a matter of survival for many patients. Yet, rapid-acting analog insulin, such as Walmart’s ReliOn Novolog, is only one component of an insulin replacement therapy regimen. Most people who use a rapid-acting analog insulin need to pair it with a long-acting analog formulation, which is not yet included under Walmart’s ReliOn brand. Studies have also shown that out-of-pocket spending on the supplies required for delivering insulin and monitoring blood sugar can be equal to or even higher than the costs of the drug itself. Thus, even with this new option, total medical costs for patients needing to manage their insulin-dependent diabetes remains unaffordable.

This is not a replacement for better health insurance. The purpose of health insurance is to protect people from the high costs of healthcare services when they need them. Yet, the U.S. system does not always ensure that all Americans have the access they require to these types of drugs. Being uninsured or facing high co-pays, deductibles, and co-insurance while insured creates barriers to access. Walmart is offering a stop-gap solution, but these broader coverage challenges remain unaddressed.

We need market and policy-based strategies to improve prescription drug access and affordability. Pharmaceutical companies claim they need to fund innovation to justify the high prices of their drugs. Yet, a government report released Thursday exposed that the company that makes brand Novolog and its competitor spent more in stock buy backs and dividend payments than on research and development in each of the past five years. The real cause of high prices among these drugs is simply pharmaceutical company greed.

What this country needs are systematic reforms that promote both increased health insurance coverage and benefit generosity, and diminish the power of pharmaceutical companies to charge any price the market will bear without regard to the financial stability of American families. There are a range of strategies for making insulin affordable for patients and payer. These include policies that increase competition among pharmaceutical manufacturers such as patent reform and payment policies that promote biosimilar use. But these policies are not enough; indeed, there is competition in the insulin market today and yet prices remain too high. What we need is to allow the Secretary of HHS to negotiate drug prices on behalf of all Americans and ensure that the resultant savings benefit patients currently struggling to afford needed medical care.

Guaranteeing affordable and equitable access to all Americans who need rapid acting insulin and other needed medical care should not be just a corporate initiative by one pharmacy, but a priority policy of the White House and the U.S. Congress.

Rena Conti, PhD, is an associate professor of public policy and law at Boston University’s Questrom School of Business. Ani Turner, MA, is a senior economist at Altarum.

Last Updated July 09, 2021