It’s true: People with diabetes can now order their insulin and other diabetes meds direct from the online retail giant Amazon, complete with free two-day shipping for Amazon Prime members.
Amazon announced on Nov. 17, 2020, that it has, at long last, launched an online pharmacy for prescription medications. The company has been moving in this direction since its 2018 acquisition of PillPack for home delivery of certain medications.
So can those of us whose lives depend on insulin expect this easy online shopping option to also bring us cost savings, to help offset the current insulin pricing crisis?
Short answer: Not for most insulins available at Amazon Pharmacy.
In fact, most prescription insulins appear to be priced on par with current pharmacies, but depending on the insulin brand the retail prices are even a bit more expensive. And some of Amazon’s pricing information is misleading and confusing.
While many in the Diabetes Community were excited to see insulin called out specifically in the press coverage announcing this, we need to take the news with a grain of salt.
DiabetesMine connected with Amazon’s public relations department as well as the insulin manufacturers Eli Lilly, Novo Nordisk, Sanofi and MannKind to get the scoop on what we can expect as to insulin sales via Amazon.
This is a new online store at Amazon, where you can shop and order in a familiar fashion to shopping for anything else on the site, via computer or mobile device.
The difference is that it’s set up to also process medical prescription and insurance information. Their motto is: “Your medication, made easy.”
After setting up a secure pharmacy profile, customers can add their insurance information, physician contact info, and medication listings to get the process moving. They can also plug in payment options and delivery information in advance of prescription approval. Amazon is offering unlimited, free, two-day delivery for Prime members, and four- to five-day delivery for non-Prime members.
For customer privacy, the shipments are sent in discreet packaging to not disclose that they contain medications, Amazon says.
Customers also have online self-service help options as well as customer care phone access at any time, and actual pharmacists are available 24/7 to answer any questions about medications.
Amazon is carrying all well-known insulin brands, but for most, there does not currently appear to be any savings over typical prices at local pharmacies around the country. See pricing details below.
Note that a discount is available for anyone who subscribes to the Amazon Prime monthly service, ranging from 25 to 40% off the retail price.
But some of the pricing is a bit misleading, as it is broken down in different increments than those commonly prescribed amounts. For example, insulin pens come in boxes of five; but Amazon breaks down the pricing for an individual pen, which is not how most of us expect to see the cost calculations.
DiabetesMine expressed these concerns to an Amazon spokesperson, and we’re told they are taking those comments under advisement.
Here are pricing details on some of the most commonly used brands. We compare Amazon’s prices to the set manufacturer’s “list price” — meaning the recommended base price without insurance or any possible rebates or markups factored in.
Novolog/Fiasp
- This fast-acting bolus insulin is priced at $488.30 for a 10 mL vial without insurance (compared to a $289.36 list price, a 68% price hike)
- $943.05 for a box of five 3 mL insulin pens (compared to a $558.83 list price)
Humalog
- Fast-acting bolus insulin runs $159 for a 10 mL vial without insurance (compared to a $274.70 list price, or a 44% discount)
- $895.05 for a box of five 3 mL KwikPens (compared to a $530.40 list price)
Note that Amazon Pharmacy initially listed a 3 mL vial of Humalog (300 units, versus the 10 mL / 1,000-unit vial) online for $87.
That’s rather misleading because most PWDs (people with diabetes) are not even aware of these smaller 3 mL vials, since the standard is a 10 mL, and doses are calculated by physicians and insurance companies based on that measure. In fact, most physicians don’t prescribe 3 mL vials for home use because those smaller vials are generally reserved for hospitals and long-term care facilities.
A spokeswoman told DiabetesMine that Amazon would soon be updating its offering to include the Humalog 10 mL vial and pricing.
Basaglar
- This long-acting basal “biosimilar” insulin is available for $550.80 for a box of five 3 mL pens (compared to a $326.36 list price)
Tresiba
- This unique extra long-acting basal insulin runs $572 for a 10 mL vial without insurance (compared to a $338.95 list price)
- $858 for a box of five Basaglar FlexTouch 3 mL insulin pens (compared to a $508.43 list price)
Lantus
- This long-acting basal insulin goes for $478 for a 10 mL vial without insurance (compared to a $283.56 list price)
- $717.75 for a box of five SoloStar 3 mL insulin pens (compared to a $425.31 list price)
Levemir
- Another long-acting basal insulin that runs $520 for a 10 mL vial without insurance (compared to a $308.14 list price)
- $780 for a box of five 3 mL insulin pens (compared to a $462.21 list price)
Afrezza inhaled insulin
- Box of 90 four-unit cartridges: $496.80 without insurance, before a 32% Prime discount (versus $354 list price)
- Box of 90 eight-unit cartridges: $938.70 with insurance, before a 28% Prime discount ($708 list price)
A representative from each of the Big Three Insulin Makers (Eli Lilly, Sanofi, and Novo Nordisk), as well as Afrezza-manufacturer MannKind Corp, told DiabetesMine they weren’t directly involved with pricing insulin at Amazon; instead, it’s Amazon’s prerogative to price and mark-up insulin as it sees fit.
An Amazon spokeswoman mentioned a “variety of factors” that go into their price-setting and said the company believes their insulin prices are “competitive” with other retail pharmacies.
But our comparison of insulin prices at various pharmacies including CVS and Walgreens in November 2020 shows that Amazon’s claim doesn’t hold water; their prices are significantly higher for all but Humalog insulin when a Prime discount isn’t applied.
So in many ways, this appears to be a big promotion to get PWDs to sign up for Amazon Prime membership, which costs $12.99 per month ($119 per year).
It is good to see that as part of the Amazon Pharmacy announcement, the online retail giant also unveiled a new savings program for Prime members who are paying without insurance: they can save up to 80% on generic drugs and 40% off brand-name meds at the time of checkout.
This is not unlike discount cards and savings programs on diabetes meds that Pharma companies offer directly to assist patients without insurance. Much like those, there are certain eligibility restrictions, such as not being accessible to those on Medicare or Medicaid.
But in the case of Amazon, more than 50,000 local pharmacies are participating in this savings program nationwide, including big-name pharmacies like CVS, Costco, and Walgreens. The savings benefit is actually administered by Inside Rx, a subsidiary of Evernorth — the newly rebranded health services division of insurance giant Cigna and pharmacy benefits manager ExpressScripts.
While Amazon Pharmacy isn’t doing much to offset the insulin pricing crisis in America, the convenience of online prescriptions and delivery is quite compelling — especially with a continuing COVID-19 crisis not expected to dissipate anytime soon.
As more people with diabetes are limiting exposure and trying to avoid in-person interactions as much as possible, having an Amazon order of insulin delivered to one’s door is a beneficial offering.
This new online pharmacy service also does help improve access to insulin, just by being so ubiquitous and easy to use.
“As more and more people look to complete everyday errands from home, pharmacy is an important and needed addition to the Amazon online store,” says Doug Herrington, Amazon’s senior VP, North America Consumer.
Still, it doesn’t address the reality that so many can’t afford insulin — and that in itself may be a barrier to using this new Amazon Pharmacy option.
For those in need of price breaks, the GetInsulin.org resource describes in detail the various savings and discount programs offered by insulin manufacturers — including the gaps and limitations attached. There is also a new grassroots Mutual Aid Diabetes effort launched recently (in November 2020), as a way to help those who are facing hardship and can’t buy insulin themselves.
We’ll have to see what impact this new Amazon Pharmacy has on pricing and access to insulin over time, if any.
There’s been mixed response within the online community.
Christine Howe in New York says she’s been getting most of her prescriptions, including insulin, for years from PillPack — even before Amazon’s acquisition — and the experience has been great.
“They’re very reliable and always ship it quickly with plenty of cool packs in a Styrofoam case,” she says. “They contact my doctor for refills without me doing anything. I just don’t love all the extra waste.”
Others point to the pricing as negative, and above all a lost opportunity.
An anonymous type 1 in California notes: “It doesn’t look like there are any great deals on insulin, at least, not for cash payers. Pricing may vary depending on insurance, though.”
Amazon is offering a benefit “only if they undercut the original manufacturer’s price and forces a race to the bottom price-wise,” says fellow type 1 Shaw Strothers in California.
In Ohio, longtime type 1 Roxanne Marie puts it simply that Amazon’s insulin prices are “absurd,”
On Instagram, @celebnavi writes: “It’s a positive in the way that there is an option (probably very expensive option) for the lag time and incidences that insurance companies and pharmacies create hoops for us to jump through to get the next Rx filled. It’s a nice backup option if needed. But the big picture is that it’s terribly sad to see that insulin is seen as retail. In our home, the same as all who need insulin, it is life support. It’s a necessity and it’s heartbreaking that there’s such a price tag on that.”
Others expressed concern about insurance rules restricting them to using a specific pharmacy.
“Our insurance has insisted we use a single particular mail-order pharmacy, which has changed a couple of times,” Stacy Scott writes on Facebook. “If Amazon were it, then I’d have to use it; if it were not, I couldn’t, not without paying full price.”