CVS debuts insulin program with no out-of-pocket costs

CVS Health recently launched an insulin program for employers and health plan sponsors to offer diabetes medications with zero out-of-pocket costs for members. The program could help alleviate the rising costs of insulin for people managing diabetes.

The program, dubbed RxZERO, does not raise costs for the plan sponsor or increase premiums or deductibles for all plan members, according to CVS. The plan is instead designed to eliminate out-of-pocket costs for all diabetes medications, not just insulin.

“Traditionally, the focus of affordability for diabetes medications has been on insulin, which is the cornerstone of therapy for the [5%] of people with diabetes who are living with type 1 diabetes,” Troyen A. Brennan, MD, MPH, executive vice president and chief medical officer of CVS Health, said in a statement. “However, the new CVS Caremark solution expands affordable options to include the entire range of diabetes medications—improving affordability for the [95%] of people with diabetes who are living with type 2 diabetes.”

Out-of-pocket costs are a major barrier to medication adherence, with 32% of patients saying they don’t feel they have the resources to manage these costs.

Members who take brand diabetes medications spend $467.24 out of pocket annually on average. Nearly 12% spend more than $1,000 annually, according to CVS Caremark, the pharmacy business of CVS Health.

CVS’s new program comes at a time when insulin prices have sky-rocketed, forcing some patients to ration their supply––a dangerous practice––or switch to older, cheaper products that can also be dangerous. The price hikes over the years have attracted the attention of some lawmakers. In response to pressure from consumers, some drugmakers have offered insulin at lower prices, but even those products have been difficult to obtain, according to some reports. Some patients, desperate for their diabetes medications, have even resorted to traveling to Canada to obtain insulin at lower prices.

Express Scripts and Cigna announced last year they would cap out-of-pocket costs for insulin users at $25 per month.

Amy Baxter

Amy joined TriMed Media as a Senior Writer for HealthExec after covering home care for three years. When not writing about all things healthcare, she fulfills her lifelong dream of becoming a pirate by sailing in regattas and enjoying rum. Fun fact: she sailed 333 miles across Lake Michigan in the Chicago Yacht Club "Race to Mackinac."

Around the web

Compensation for heart specialists continues to climb. What does this say about cardiology as a whole? Could private equity's rising influence bring about change? We spoke to MedAxiom CEO Jerry Blackwell, MD, MBA, a veteran cardiologist himself, to learn more.

The American College of Cardiology has shared its perspective on new CMS payment policies, highlighting revenue concerns while providing key details for cardiologists and other cardiology professionals. 

As debate simmers over how best to regulate AI, experts continue to offer guidance on where to start, how to proceed and what to emphasize. A new resource models its recommendations on what its authors call the “SETO Loop.”