June 30, 2021

Our take: Walmart just launched its own insulin brand

Daily Briefing

    Walmart on Tuesday announced that it has partnered with Novo Nordisk to sell its own brand of rapid-acting analog insulin for cash prices that are significantly lower than current list prices, but advocacy groups offered mixed reactions on what the move will mean for patients.

    The executive's guide to pharmacy issues

    Walmart launches exclusive insulin brand

    Walmart's insulin brand, called ReliOn NovoLog Insulin, will be priced at $72.88 for a 10 mL vial and $85.88 for a five-pen box of Novo Nordisk's FlexPens.

    According to Walmart, these prices will save customers between "58% to 75% off the cash price of branded analog insulin products, which translates to a savings of up to $101 per branded vial or $251 per package of branded FlexPens." The price actually paid by patients varies, however, depending upon their insurance coverage.

    The new insulin brand will be available in Walmart pharmacies this week and in Sam's Club pharmacies in mid-July, Walmart said. Consumers who want to purchase the drug will require a prescription.

    "Diabetes is one of the fastest growing diseases in the country," Cheryl Pegus, Walmart Health & Wellness EVP, said. "We know many people with diabetes struggle to manage the financial burden of this condition, and we are focused on helping by providing affordable solutions. We also know this is a condition that disproportionately impacts underserved populations."

    The pricing of the new brand relative to existing options, Pegus argued, "is real innovation."

    Diabetes advocacy groups offer mixed reactions to Walmart's announcement

    More than 29 million people in the United States have diabetes, and around 7.4 million use insulin, STAT News reports. However, research has found that many people skip insulin doses because of cost.

    For instance, one 2019 study found that, within a 12-month period, 13.2% of people skipped or took fewer doses of prescribed diabetes medication, or delayed filling a prescription, while 24.4% asked their doctor for a less expensive alternative.

    Tracey Brown, CEO of the American Diabetes Association, said Walmart's move could help address this affordability problem. "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," Brown said. "We encourage everyone to ask their health care provider questions to better understand what the right and affordable treatment is for their unique medical needs."

    But Elizabeth Pfiester, founder and executive director of the advocacy group T1International, suggested that even Walmart's price was too high. "For people [who] need two to three vials of insulin per month—and most people with diabetes need at least that, or often more—this is not enough to end the insulin price crisis or to put a stop to our question of why manufacturers are charging even $72 per vial when estimates say it costs about $6 per vial to produce," Pfiester said. (Walmart release, 6/29; Herman, Axios, 6/30; Minemyer, Fierce Healthcare, 6/29; Japsen, Forbes, 6/29; Silverman, STAT+ [subscription required], 6/29).

     

    Advisory Board's take

    A 'win/win' for Walmart and Novo Nordisk—but should PBMs be concerned?

    This move seems like a win/win for Walmart and Novo Nordisk. Walmart may attract more diabetes patients, who likely will bring other prescriptions to their pharmacies and also purchase their diabetes supplies and other household needs at Walmart stores. And Novo Nordisk may stabilize or grow their market share while still pocketing a similar net price as they've negotiated with PBMs for their existing insulin products, according to an Axios analysis.

    Walmart's move seems to be part of a burgeoning trend toward private labeling for retail medications. Just a few weeks ago, Anthem was the latest health plan to join CivicaScript, part of CivicaRx, which plans to manufacturer common, high-cost generic medications and distribute the private-label products through retail and mail-order pharmacies. 

    The stakeholders who perhaps should be most concerned about this development are PBMs. Health care leaders, pharmaceutical manufacturers, and policymakers have been criticizing PBMs' role in driving up drug prices for years. While a key PBM role in the drug supply chain is negotiating discounts to lower net drug costs, it's not always clear who benefits from those rebates. Patients may not benefit from lower net drug costs if some of that savings is kept by the PBM or the health plan in order to lower overall premium costs—or as profit.

    We'll be watching whether more consumer-oriented companies (read: Amazon) can drive enough market share to launch private-label drugs of their own or if new alliances form to circumvent the established stakeholders for other high-cost generics.

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