Nonprofit Will Sell $30 Insulin Direct to Patients Starting in 2024

by Peter Johnson

CivicaRx, the nonprofit drug manufacturer owned by a consortium of health systems and health plans, aims to release a line of three insulins — glargine (Lantus), lispro (Humalog) and aspart (Novolog) — as soon as 2024. Those insulins will be available in vials or prefilled pens and will be priced at “no more than $30 per vial and no more than $55 for a box of five pen cartridges” for all consumers, regardless of whether they have insurance; the products will soon be submitted for review for interchangeable biosimilar approval by the FDA. 

CivicaRx could meaningfully lower prices 

• The CivicaRx initiative could do something that existing proposals to cap the price of insulin would not: It may actually lower the list price of insulin products. 
• Ge Bai, Ph.D., tells AIS Health, a division of MMIT, that she expects the insulins will set the standard price in their category when they become available.
• Bai says the program will go beyond “just the direct effect that patients have to go to CivicaRx to get the $30 per month price.” Rather, “the ripple effect means other competitors understanding the CivicaRx pricing strategy — they have to respond and change their own pricing behavior to retain a market share. So that’s why I feel it is disruptive to some extent.”
• “I agree that with this Civica announcement, there will be downward pressure on insulin prices,” Elan Rubinstein, Pharm.D., principal of EB Rubinstein Associates, tells AIS. However, he adds that “the big unknown that would trump this and similar initiatives would be if the Biden administration is successful in passing legislation to permit the federal government some level of regulation over Medicare drug prices — because that would likely impact drug pricing generally.” 

CivicaRx will bypass PBMs, rebates 

• Gina Guinasso, president of CivicaScript, CivicaRx’s consumer drug brand, tells AIS Health that the group doesn’t plan to contract with PBMs. Civica also will not pursue rebates, she adds.
• “There’s a lot of opaqueness in how manufacturers work with PBMs,” says Guinasso. “We don’t anticipate contractual relationships [with PBMs], because there’s no rebates, but certainly we would applaud any PBM that wants to put low-cost insulin on formulary.”
• When the insulins do come to market, Guinasso says that CivicaRx will contract directly with wholesalers and retailers.
• The same agnostic approach applies for wholesalers, Guinasso adds, and negotiations are at the same stage. She adds that CivicaScripts hopes to start selling the insulins nationally at launch, without phased, regional rollouts.
• “It’s too early to comment specifically on the wholesale channel,” she says. “But we will be taking the same approach that I just described with anybody in the distribution channel. So aligning to our philosophy on pricing, the patient being at the center of everything and making decisions all wholly based on what’s in the best interests of the patients.” 

From Radar on Drug Benefits

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