Walmart to Sell Cheaper Insulin; Advocates Say It's Still Expensive

Miriam E. Tucker

June 30, 2021

The retail giant Walmart has launched its first private brand of analog insulin in the United States called ReliOn Novolog (insulin aspart).

The new product will cost $72.88 per vial and $85.88 for a package of FlexPens. This represents savings of 58% to 75% off the cash price of branded analog products, or up to $101 per branded vial and $251 per FlexPens package, according to the company.

The products will be available at Walmart pharmacies across the United States this week and at Walmart subsidiary Sam's Club pharmacies in mid-July. Like the brand-name Novolog, they will also be manufactured by Novo Nordisk and require a prescription. The products are intended for use by patients with type 1 or type 2 diabetes.

Walmart's other ReliOn insulins — NPH, Regular, and 70/30 mix — are all human rather than analog insulin and sell for about $25 a vial.

Analog insulin is generally preferred because its action is more physiologic and it allows for more flexible dosing.

The biosimilar rapid-acting lispro analog insulin (Admelog, Sanofi) retails for about $150 a vial, and Lilly's "authorized generic" lispro costs about $137 per vial.

Asked to comment, Jing Luo, MD, assistant professor of medicine, Center for Pharmaceutical Policy and Prescribing, University of Pittsburgh, Pennsylvania, told Medscape Medical News: "I think it's a small incremental advance in pricing for Novo-branded rapid-acting insulin analogs...akin to what Lilly did in releasing authorized generic Lispro at a reduced price. For patients without insurance, they do represent a substantial savings off the sky-high list prices. Whether they are worth the extra cost when compared to Walmart-branded human insulin vials is debatable."

He also pointed out that it's not clear why Walmart launched a rapid-acting analog prior to a longer-acting one, but that it was likely for business reasons.

Organizations React Positively, Yet Caution More Work Is Needed

In a Walmart statement, Tracey D. Brown, chief executive officer of the American Diabetes Association, said: "Diabetes often comes with high medical costs, estimated around $9,601 per person per year. We welcome all affordable solutions that make diabetes management more accessible to millions of Americans living with diabetes. We encourage everyone to ask their healthcare provider questions to better understand what the right and affordable treatment is for their unique medical needs."

(Prior to becoming ADA CEO in 2018, Brown was chief membership & marketing officer and also senior vice president of operations and chief experience officer for Sam's Club.)

The type 1 diabetes research and advocacy organization JDRF stated: "JDRF welcomes Walmart's announcement regarding their plan to offer lower-cost insulin...For people with type 1 diabetes, insulin is a lifesaving drug that no one should ever have to ration or go without. No one should die because they can't afford their insulin. JDRF has long advocated for affordable and predictable out-of-pocket costs of insulin. The rising cost of insulin is a fundamental issue faced by those living with diabetes, and JDRF applauds this new effort."

However, JDRF also noted, "While today's announcement is a step toward making insulin affordable for everyone, more needs to be done. JDRF will continue to urgently drive long-term efforts and push for action from manufacturers, health plans, employers, and the government to remove accessibility barriers."

And in a statement from Beyond Type 1, an advocacy group that partners with Novo Nordisk, chief advocacy officer Christel Marchand Aprigliano said: "The launch of Walmart's private-label ReliOn analog insulin is one step closer to ensuring that no one rations or dies from lack of affordable access to insulin in the United States, but longer-term systemic change is needed. We look forward to the elimination of more barriers through both commercial innovation and legislative policy efforts."

Some Advocates Say the Cost Is Still Too High

On Twitter, however, some people disputed Walmart's claim that the new products "will revolutionize the access and affordability to diabetes care," pointing out that the $73/vial price tag is still too steep for many and far more than the price of analog insulin in other Westernized countries.  

Long-time diabetes advocate Kelly Rawlings (@KellyRawlings) tweeted: "Rapid-acting insulin analog (for mealtime dosing): Walmart's private label insulin brand pen or vial, for diabetes. Vial $72.88. Why not $7.30?"

And Hilary Koch (@HilaryKochME), policy manager for T1International, an advocacy organization that does not take pharma funding, tweeted: "Walmart insulin for $75? Even my 15yo figured out that this was a smokescreen to keep lawmakers from taking real action. $75 x 3 = $225...Hey, Pharma. We see through you. We need a federal price cap. #insulin4all"

According to Luo, "Yes, the price is still expensive — higher priced than many, if not most, comparable products easily found in Canadian pharmacies."

Luo has reported no relevant financial relationships.

Miriam E. Tucker is a freelance journalist based in the Washington, DC, area. She is a regular contributor to Medscape, with other work appearing in The Washington Post, NPR's Shots blog, and Diabetes Forecast magazine. She is on Twitter: @MiriamETucker.

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