Despite outrage over the high cost of insulin, prices for popular insulin treatments have continued to climb in 2019, according to a GoodRx analysis of drug prices. Though prices are not climbing as quickly as they did between 2002 and 2013—when the average cost of insulin therapy nearly tripled—the average price* of insulin has increased by 55% since the first quarter of 2014.

The analysis also shows that price increases this year affected a select group of insulins: mainly long-acting insulins, those that control blood sugar throughout the day, and Afrezza, the inhaled, ultra-rapid-acting insulin made by MannKind.

The average retail price for Afrezza has gone up by 8% since the fourth quarter of last year. And average retail prices for long-acting insulins made by Sanofi-Aventis and Novo Nordisk increased by as much as 6% during the same period, calling into question the pledges these manufacturers made to help rein in insulin prices. In 2017, Sanofi-Aventis had vowed to limit annual price increases to a rate below medical inflation (effectively 5.4%). And Novo Nordisk promised just months before to cap annual price increases to single-digit percentages.

The analysis on 23 insulins across manufacturers and insulin types—short-, intermediate-, rapid- and long-acting—shows that manufacturers are still raising insulin prices, and costs now vary by as much as 10 times depending on which insulin you take. Here, we’ll walk you through how each insulin stacks up and how you can get the best deal on these life-saving medications.



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This GoodRx analysis is based on a representative sample of U.S. prescription fills (not GoodRx fills) and comes from several sources, including pharmacies and insurers. The reported prices per insulin unit are based on cash prices, the so-called “usual and customary” prices or retail prices at the pharmacy (not including insurance copays or co-insurance).

A note about insulin use:

One insulin unit can be defined as the amount of insulin it takes to lower blood glucose by 50 mg/dL, although each individual’s response is highly variable. Someone with type 2 diabetes may start with 1 unit of insulin per 1 kg to 2 kg of bodyweight per day, which equates to about 40 units of insulin per day for a 70 kg person.

People with type 2 diabetes are often treated without insulin—or perhaps one type of intermediate- or long-acting insulin—as type 2 diabetes is a disease where the body is resistant to insulin’s effects. For those with type 1 diabetes, an autoimmune disorder that kills pancreatic cells that make insulin, more insulin of different types is needed. It’s common, for example, for a person with type 1 diabetes to use both a mealtime (rapid- or short-acting) insulin along with a basal (intermediate- or long-acting) insulin.

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How do insulin prices compare today?

1) Traditional insulins are cheaper than modern insulins

Average retail prices of Novolin and Humulin (traditional short- and intermediate-acting insulins) have gone down, while prices of modern rapid- and long-acting insulins continue to go up. On average, traditional insulins now cost less than half of what modern insulins cost.

Why? Understandably, traditional insulins have always been cheaper than their newer competitors. Modern insulins offer better blood sugar control but are synthetic analogs of traditional insulins, which makes them more difficult to produce.



Additionally, when patents on Humulin and Novolin expired around 2000, manufacturers Eli Lilly and Novo Nordisk had to test new pricing strategies to remain competitive.

In 2017, for example, Novo Nordisk partnered with CVS to offer Novolin at roughly 80% less than its normal list price. Both Novo Nordisk and Eli Lilly have also worked with Walmart to heavily discount Novolin and Humulin under Walmart’s ReliOn line of insulin products.

Retail partnerships haven’t been their only strategy. In May 2017, Eli Lilly broke from their routine of increasing Humulin prices every 6 months and has since left prices alone. In fact, prices of traditional Humulin and Novolin insulins, their rapid-acting analogs (Humalog and Novolog), and their mixed products (e.g., Humulin 70/30, Novolog 70/30) have not gone up since then.

Novolin R and Novolin N are currently the cheapest traditional insulins, by as much as 77% compared to other options.

Retail Prices of Traditional Insulins (Q2 2019)

Price per dispenser Price per insulin unit Regular insulin Novolin R vial (10 mL) $93 per vial $0.09 per unit Humulin R vial (10 mL) $185 per vial $0.19 per unit Humulin R vial (20 mL, 500 units/mL) $1,813 per vial $0.18 per unit Humulin R KwikPen (3 mL, 500 units/mL) $352 per pen $0.23 per unit NPH insulin Novolin N vial (10 mL) $92 per vial $0.09 per unit Humulin N vial (10 mL) $183 per vial $0.18 per unit Humulin N KwikPen (3 mL) $117 per pen $0.39 per unit

*Insulin concentrations are 100 units/mL unless otherwise stated.

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2) Vials are cheaper than newer dispensers

In 1985, Novo Nordisk introduced the first insulin pen, making it more convenient for patients to store and self-inject insulin—but it came at a price. Today, retail prices of rapid-acting insulins are about 30% higher if you opt for pens instead of vials. This trend isn’t just relevant to rapid-acting insulins; the average retail price of Humulin N, for example, more than doubles if you choose to use a KwikPen instead of a vial.



New dispensers make insulin more expensive. We’re seeing that again with Afrezza, the only insulin to be delivered as an inhalable powder. One unit of Afrezza’s insulin can cost as much as 6 times the price of other rapid-acting insulins. (Afrezza’s manufacturer, MannKind, offers the medication at reduced costs through its direct purchase program.)

Retail Prices of Rapid-Acting Insulins (Q2 2019)

Price per dispenser Price per insulin unit Insulin lispro Generic insulin lispro vial vial (10 mL) $180 per vial $0.18 per unit Generic insulin lispro KwikPen (3 mL) $72 per pen $0.24 per unit Admelog vial (10 mL) $291 per vial $0.29 per unit Admelog SoloStar pen (3 mL) $187 per pen $0.37 per unit Humalog vial (10 mL) $332 per vial $0.33 per unit Humalog KwikPen (3 mL) $133 per pen $0.44 per unit Humalog KwikPen (3 mL, 200 units/mL) $264 per pen $0.44 per unit Humalog cartridge (3 mL) $132 per cartridge $0.44 per unit Humalog junior KwikPen (3 mL) $129 per pen $0.43 per unit Insulin aspart Novolog vial (10 mL) $351 per vial $0.35 per unit Novolog FlexPen (3 mL) $134 per pen $0.45 per unit Novolog cartridge (3 mL) $130 per cartridge $0.47 per unit Fiasp vial (10 mL) $348 per vial $0.35 per unit Fiasp FlexTouch pen (3 mL) $136 per pen $0.45 per unit Insulin glulisine Apidra vial (10 mL) $362 per vial $0.36 per unit Apidra SoloStar pen (3 mL) $143 per pen $0.48 per unit Inhaled insulin Afrezza cartridge (4 units) $4.42 per cartridge $1.11 per unit

*Insulin concentrations are 100 units/mL unless otherwise stated.

3) Follow-ons and generics cost less than brands

Generic medications contain exact replicas of the active ingredients in their brand-name counterparts. Different manufacturers can copy the chemical structures of those ingredients, which allows multiple generics to compete in the market and lower prices. In the world of biologic medications, which are derived from living organisms, generics are virtually impossible to make. We call the different manufacturer copies of biologics “follow-ons,” as they only closely copy the brand-name drugs.

Basaglar, a long-acting insulin approved in 2016, is the follow-on to Lantus, and Admelog, a rapid-acting insulin approved in 2017, is the follow-on to Humalog. By the end of the second quarter of 2019, the average retail price of Basaglar was about 20% less than Lantus on a per insulin unit basis. Similarly, Admelog’s average retail price was 12% to 16% less than Humalog’s, depending on the dispenser.

By retail price alone, Basaglar is the cheapest option of the long-acting insulins. However, earlier this year, manufacturer Eli Lilly released a generic version of their popular rapid-acting insulin, Humalog—and that generic was cheaper than Admelog. If you compare prices by dispenser, generic insulin lispro was about 45% cheaper than Humalog in Q2.



4) New product features can come with a high price tag

Novelty can translate to higher prices (as we saw with Afrezza)—but not always. We recently gained 3 new combination insulin medications: Xultophy, Soliqua 100/33, and Fiasp. Tresiba, an ultra-long-acting insulin, also came to market in the last few years.

Xultophy and Soliqua both contain a long-acting insulin and another non-insulin diabetes medication. Xultophy is a mix of insulin degludec plus liraglutide (the same active ingredient in Victoza), and Soliqua is a mix of insulin glargine plus lixisenatide (the same active ingredient in Adlyxin). Average retail prices for Soliqua and Xultophy are more than double the price of cheaper alternatives like Basaglar and Tresiba, which have the same exact kind of insulins.

Fiasp contains insulin aspart, the same insulin in Novolog, but it also has vitamin B3. This added ingredient may speed up insulin absorption but doesn’t necessarily make Fiasp more effective than Novolog at lowering blood sugar. Interestingly, the retail prices for Fiasp and Novolog are the same on a per insulin unit basis.



Then there’s Tresiba, an ultra-long-acting insulin that stays active for up to 42 hours. For this unique property, its average retail price is about $124 per 3 mL pen (100 units/mL), or 53% more than fellow long-acting insulin, Basaglar.



Along with these new formulations, insulin manufacturers have also started offering their insulins at higher concentrations to make them more convenient for people who need more insulin than average. Humulin R, Humalog, and Tresiba all come in higher-concentration versions, and Toujeo is a higher-concentration version of Lantus. At first glance, their prices may seem high, but they actually go for the same per unit retail price as their lower-concentration counterparts.

What’s next for insulin prices? At the end of 2017, long-acting insulins started to get more expensive, after having enjoyed stable prices since 2015. These price increases have not stopped. As we mentioned, Novo Nordisk and Sanofi-Aventis raised their insulin prices again this year, despite promising to help rein in drug prices.

But insulin lispro, the first generic insulin, also made it to market this year, and it was released at about half the price of its brand counterpart, Humalog. Will this mark the beginning of more generics and price shifts as competition heats up? We’ll have to wait and see.

Retail Prices of Long-Acting Insulins (Q2 2019)

Price per dispenser Price per insulin unit Insulin detemir Levemir FlexTouch pen (3 mL) $113 per pen $0.38 per unit Levemir vial (10 mL) $397 per vial $0.40 per unit Insulin glargine Basaglar KwikPen (3 mL) $81 per pen $0.27 per unit Lantus vial (10 mL) $340 per vial $0.34 per unit Lantus SoloStar pen (3 mL) $168 per pen $0.34 per unit Toujeo pen (1.5 mL, 300 units/mL) $160 per pen $0.35 per unit Toujeo Max pen (3 mL, 300 units/mL) $315 per pen $0.35 per unit Soliqua 100/33 SoloStar pen (3 mL) $173 per pen $0.58 per unit Insulin degludec Tresiba vial (10 mL) $417 per vial $0.42 per unit Tresiba FlexTouch pen (3 mL) $124 per pen $0.41 per unit Tresiba FlexTouch pen (3 mL, 200 units/mL) $248 per pen $0.41 per unit Xultophy pen (3 mL) $254 per pen $0.85 per unit

*Insulin concentrations are 100 units/mL unless otherwise stated.

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Ways to save on insulin

It’s difficult to predict where drug prices will be in the future, but if you take insulin, we hope our analysis gives you some ideas for how to talk to your doctor about affordable options. Here are more ways you can save:

Use a manufacturer savings card or patient assistance program. Major insulin manufacturers Eli Lilly, Novo Nordisk, Sanofi-Aventis, and MannKind offer copay cards and patient assistance programs for patients with and without insurance coverage. In many cases, these programs can reduce out-of-pocket costs to as little as $0 per month. For more information, just search for your drug on goodrx.com, and click on “Savings Tips” for details. Shop around. GoodRx offers coupons on insulin drugs, which can save you as much as 50% off the full retail price. At goodrx.com, you can also compare insulin prices at different pharmacies in your area and find information about discount programs at specific pharmacies. Appeal your coverage. If you have insurance and your plan doesn’t cover the insulin you need, ask your doctor about submitting an appeal. Your insurance company may require a prior authorization or step therapy before you can fill your prescription, but it’s worth trying if you want to get your insulin covered.

Co-contributors: Diane Li, Jeroen van Meijgaard, PhD, and Clement B. Feyt, MPH