HOW MUCH INSULIN COSTS WITH AND WITHOUT INSURANCE AND HOW SINGLECARE CAN MAKE IT MORE AFFORDABLE
Key takeaways
- The average retail price of insulin nearly doubled between 2012 and 2021, creating significant affordability challenges for many people who rely on insulin to manage diabetes.
- Recent policy changes and FDA approvals of generic insulin and biosimilar insulin products have helped increase access and contribute to lower insulin costs.
- Although insulin list prices can still be high, many eligible patients may now access insulin for $35 or less per month through insurance benefits, manufacturer savings programs, assistance programs, and other cost-saving options. Various strategies, including prescription discount programs, may also help reduce out-of-pocket expenses
Insulin is a hormone naturally produced by the body that helps regulate blood sugar levels. People with Type 1 diabetes do not produce enough insulin on their own and require insulin therapy to survive. Many people with Type 2 diabetes may also need insulin as the condition progresses and the body becomes less able to maintain healthy blood sugar levels.
For many years, the high cost of insulin has been a major concern for people who depend on this medication. However, recent legislation, increased market competition, and the introduction of lower-cost insulin options have helped make insulin more affordable for many Americans.
What’s changed with insulin prices recently?
Since 2020, the average cost of insulin has decreased significantly. This shift has been linked to several factors, including the approval of biosimilar and generic insulin products, as well as the introduction of federal and state policies that place limits on insulin costs for eligible patients.
Price caps
Legislation related to insulin pricing continues to change, but several recent measures have helped reduce out-of-pocket insulin costs for many Americans and U.S. residents:
- State-regulated commercial health insurance price caps: According to the American Diabetes Association (ADA), some states have established limits on insulin copays for people with commercial insurance, with caps generally ranging from $25 to $100 per month.
- Federal price caps: The Inflation Reduction Act established a $35 monthly insulin copay limit for eligible people with Medicare Part B and Part D coverage.
- Proposed nationwide price caps: The INSULIN Act has proposed limiting insulin costs to $35 per month for people with private insurance. The status and outcome of proposed legislation can change over time.
Manufacturer price changes
Following the Inflation Reduction Act, several insulin manufacturers also made voluntary efforts to reduce insulin prices. In addition, the approval of generic and biosimilar insulin products has helped increase competition and improve affordability.
Generic medications are typically less expensive than brand-name versions, and increased availability of lower-cost alternatives can encourage manufacturers to reduce prices for existing brand-name products as well.
While some insulin products still have high list prices, many patients are seeing lower out-of-pocket costs through price reductions, insurance changes, savings programs, and increased competition. This can make insulin more accessible for people who depend on it for diabetes management.
How much is insulin without insurance?
The short answer: Many people without insurance may now pay $35 or less per month for insulin itself, although additional costs for diabetes supplies and other healthcare needs may still apply.
According to the American Diabetes Association (ADA), insulin has not always been this affordable. For many years, insulin prices increased significantly, nearly doubling from 2012 to 2021, according to the Health Care Cost Institute (HCI).
Several factors have contributed to recent price reductions, including changes to the Medicaid Drug Rebate Program, increased public attention, and greater competition from generic and biosimilar insulin products.
The three major insulin manufacturers in the U.S.—Eli Lilly, Novo Nordisk, and Sanofi—have introduced lower prices for some insulin products and expanded financial assistance programs to help eligible patients manage costs. While prices can vary depending on the insulin type, location, and eligibility for savings programs, these changes have helped make insulin more affordable for many people.
Average cost of insulin per month
By retail price alone, monthly insulin costs can range from hundreds to thousands of dollars. However, the amount a person actually pays depends on several factors, including:
- Insurance coverage
- The insulin brand and type prescribed
- The amount of insulin needed
- Eligibility for savings programs or financial assistance
Many people may qualify for lower-cost options instead of paying the full cash price.
Estimated insulin costs in 2026 by manufacturer:
- Eli Lilly insulins (Basaglar, Humalog, Insulin Lispro, Lyumjev, and Humulin):
Eligible U.S. residents without insurance may be able to access Lilly insulin products for $35 per month through the Lilly Insulin Value Program. - Novo Nordisk insulins (Awiqli, Fiasp, Novolin, NovoLog, and Tresiba):
Some uninsured patients may qualify for free insulin or insulin for $35 per month through Novo Nordisk savings programs, depending on eligibility. - Sanofi insulins (Admelog, Apidra, Lantus, Merilog, Soliqua, and Toujeo):
Eligible uninsured U.S. residents may receive Sanofi insulin products for $35 per month through the Insulins Valyou Savings Program. - Non-branded or biosimilar insulins:
Costs vary depending on the specific product, dosage, insurance coverage, and eligibility for patient assistance programs. Ask your healthcare provider or pharmacist about available savings options.
Additional diabetes supplies that may add to costs:
People who use insulin may also need supplies such as:
- Blood glucose monitor
- Test strips
- Lancets
- Insulin delivery systems, such as insulin pumps or other devices (costs vary by brand and coverage)
The total cost of diabetes care depends on individual needs, insurance coverage, and available assistance programs. Fortunately, savings programs and cost-support options can help many people reduce their out-of-pocket expenses.
How much is insulin with insurance?
The cost of a vial or insulin pen through insurance can be difficult to predict because coverage varies by plan. Your out-of-pocket cost may depend on your insurance type, the insulin product prescribed, copays, deductibles, and eligibility for savings programs.
Here is what you may expect based on your insurance coverage:
- If you have Medicare Part D or Medicare Part B:
The Inflation Reduction Act limits eligible Medicare patients’ insulin costs to $35 per month. - If you have Medicaid:
According to the ADA, many Medicaid enrollees may receive certain insulin products at no cost or at a significantly reduced price. Coverage varies by state, so check with your State Medicaid Agency for covered insulin options. - If you have commercial insurance:
Costs vary widely depending on your insurance plan, insulin copay, and whether you have reached your annual deductible.
According to Michael Carnathan, MD, insurance coverage can sometimes make insulin affordability more complicated because some plans may cover certain insulin products differently. In some situations, patients may be switched to older, lower-cost insulin options such as NPH insulin or Novolog 70/30, when appropriate. These older insulin types have been available for many years and may require careful adjustment by a healthcare provider.
The good news is that some manufacturers offer savings programs that may reduce insulin costs for eligible patients:
- Sanofi: Eligible commercially insured patients may qualify for copay savings that limit costs to $35 or less per 30-day supply.
- Novo Nordisk: Eligible commercially insured patients may use savings programs that can reduce insulin copays to as low as $35 for qualifying products and time periods.
- Eli Lilly: Eligible commercially insured patients may qualify for savings programs that limit insulin costs to $35 or less at participating pharmacies.
For help finding available savings options, visit the insulin manufacturer’s website or speak with your healthcare provider or pharmacist. They can help identify manufacturer assistance programs, copay cards, or discount options that may lower your insulin costs.
How to save on insulin
1. Apply for a patient assistance program
As mentioned above, the three major insulin manufacturers in the U.S.—Eli Lilly, Novo Nordisk, and Sanofi—offer programs that may help eligible patients access insulin at a reduced cost or, in some cases, for free. Each program has its own eligibility requirements, and availability may vary depending on a person’s financial situation, insurance status, and other factors.
“If you do not have insurance, the pharmaceutical companies that make insulin products offer patient assistance programs,” explains Dr. Carnathan. “Most of the time, the patient can get the insulin for free or at a very reduced cost.”
Patients who are having difficulty affording insulin can also speak with their healthcare provider or pharmacist about available assistance programs and cost-saving options.
2. Check your insurance coverage
If you have insurance, one of the first steps to reduce insulin costs is to review your prescription coverage before filling your medication. Every insurance plan has a drug formulary, which is a list of covered medications organized into different tiers.
Generally, medications placed on higher tiers may have higher out-of-pocket costs for patients. Checking your plan’s formulary can help you understand your expected insulin costs, identify lower-cost covered alternatives, and avoid unexpected expenses.
Reviewing your prescription benefits can also help you decide whether changing health insurance plans during the next Open Enrollment Period could provide better coverage for your diabetes medications.
3. Consider switching diabetes medications
Insulin prices can vary significantly depending on the product, manufacturer, and coverage options. If your insurance plan does not cover your current insulin or you do not have health insurance, talk with your healthcare provider about whether a more affordable insulin option may be appropriate for your treatment plan.
Some lower-cost alternatives may include generic versions of certain insulin products, such as Humalog and Novolog, as well as certain biosimilar insulin products that may cost less than some brand-name options.Never switch insulin types or doses on your own. Your healthcare provider can help determine whether an alternative insulin is safe and effective for your specific needs.
Insulin cost FAQs
What is the average cost of insulin in the U.S. per month?
Does insurance cover insulin?
While many insurance plans cover insulin, not every plan covers every insulin product. Coverage, copays, deductibles, and preferred insulin brands can vary between insurance providers and plans.
Before filling a prescription, check your insurance formulary or speak with your insurance provider to understand your expected out-of-pocket insulin costs and whether lower-cost covered alternatives are available.
Are there generic versions of insulin?
Yes, the Food and Drug Administration (FDA) has approved generic insulin products, including versions of insulin such as insulin aspart and insulin lispro.
In 2021, the FDA also approved the first biosimilar insulin product, Semglee (insulin glargine-yfgn), providing another option for some patients who need insulin therapy.
The availability of generic and biosimilar insulin products has helped increase competition in the insulin market, which may contribute to lower costs and improve access for eligible patients.
What is the Affordable Insulin Now Act?
The Affordable Insulin Now Act was introduced in the Senate in 2022 with the goal of lowering monthly out-of-pocket insulin costs for people with diabetes. The proposed legislation aimed to limit insulin costs to $35 per month or 25% of an insurance plan’s negotiated price, whichever was lower, for people with private insurance and Medicare.
Ultimately, the $35 monthly insulin cost cap was implemented for Medicare beneficiaries through later legislation. In addition, several insulin manufacturers have introduced savings programs and price caps that may allow eligible people with commercial insurance to pay $35 or less per month for certain insulin products. Eligibility and coverage details vary by program and insurance plan.
Source: SingleCare