Letitia James

Insulin prescription costs are now capped at $35 a month for uninsured New Yorkers.

State Attorney General Letitia James announced the agreement with Eli Lilly and Company and Sanofi-Aventis U.S. LLC.

An investigation by the Office of the Attorney General 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 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.

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 for patients and the companies 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.