Retail giant Walmart has just added a key offering to its lineup of affordable insulins: a new ReliOn version of Novolog rapid-acting mealtime insulin that’s available at a fraction of the cost of the original name brand.

On June 29, Walmart announced it would be adding this rapid-acting insulin to the much older human insulins that it’s sold under the ReliOn brand for more than two decades. This is the first time Walmart’s offered a newer analog version of insulin — modified for quicker and more effective action — in its low-cost medication lineup.

Significantly, this version of Novolog insulin will cost between 58 and 75 percent less than the current cash list price at most retail pharmacies. This will allow many people with diabetes (PWDs) to get this life-critical medication without insurance, an important factor given the number of uninsured and underinsured, and those struggling with high-deductible insurance plans.

“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. With ReliOn NovoLog insulin, we’re adding a high quality medication for diabetes to the already affordable ReliOn line of products and continuing our commitment to improve access and lowering cost of care,” Dr. Cheryl Pegus, executive vice president of Walmart Health & Wellness, said in a statement.

While this move by Walmart certainly doesn’t solve the insulin pricing crisis in America and it won’t help everyone (especially those who can’t use Novolog for whatever reason), it is a big step that can help a lot of people who desperately need a path to affordable insulin.

DiabetesMine talked to spokesfolk from both Walmart and Novo Nordisk to get the full details that PWDs need to know.

Of course, the pricing is what matters here.

  • $72.88 per glass vial (10mL each, or 1,000 units)
  • $85.88 for a box of five FlexPens (each with 3mL, or 300 units)

By comparison, the cash list price for name brand Novolog is $289.36 for a 10mL vial and $559 for a box of five insulin pens.

With those high list prices in mind, Walmart touts that customers will save 58 to 75 percent off the retail list price of Novolog, which translates to a savings of up to $101 per branded vial or $251 per package of branded FlexPens.

Novo Nordisk’s media relations director Michael Bachner told DiabetesMine that Walmart set the pricing, as the ReliOn program is managed by the retailer and not the pharmaceutical manufacturer.

Keep in mind that purchasing this ReliOn Novolog insulin will require a prescription from a healthcare professional.

Walmart started selling this in its pharmacies across the United States during the week of July 1, 2021. It will be available in Sam’s Club locations across the United States in mid-July.

Yes, it is.

Novolog is a rapid-acting insulin analog approved by the Food and Drug Administration (FDA) for both children and adults with type 1 and type 2 diabetes to use for mealtime doses and high blood sugar corrections. Made by Danish pharma giant Novo Nordisk, it’s one of the most common insulins in use, administered via syringe and vial, insulin pen or through an insulin pump. Novolog has been around since 2000, following Eli Lilly’s Humalog that was the first new rapid-acting analog insulin 4 years earlier.

This Walmart version called “ReliOn Novolog” is the same drug as regularly-branded Novolog, just with a different name on the product. So, skeptics who say, “the quality will be what you pay for” are simply incorrect; it’s the exact same insulin.

Think of it like the same water (or insulin) coming out of the same tap at the manufacturer’s facility, but going into a different bottle or pen with a slightly revised label.

Walmart has sold its private label of ReliOn insulin since 2000, with Novo’s insulin being the co-branding partner for most of those years, except for 2010 to 2012 when Eli Lilly nabbed the contract for its insulins to be co-branded as ReliOn.

Until now, the only so-called “Walmart insulin” you could get for a lower price (roughly $25 to $35 per vial) was the older, human versions of insulin — R (or Regular) insulin, N (which is Novolin, aka NPH insulin); and a 70/30 mix of the two other types. Those formulations have been around since the early 1980s, but they work much differently and are seen as much less reliable than the analog insulins that first started appearing in the later 1990s. It’s the latter that most know and use these days: Humalog or Novolog rapid-acting, and longer-acting basal (background) insulin including Lantus, Levemir, Tresiba, or Toujeo.

New ReliOn Novolog brings a better, faster-acting bolus insulin as an option at Walmart for the first time.

As always, it’s important to talk with your healthcare team about whether this or any insulin might be best for you.

Not exactly, though many in the Diabetes Community may describe it as such.

The term “generic” has been loosely applied to copycat versions of name brand insulins sold at lower prices, or to older, less reliable forms of human insulin. But the reality is there are no true generic insulins available — defined as chemically identical to brand-name products and with the same efficacy, but sold at much cheaper prices.

This is also not the same as the “authorized generics” that both Lilly and Novo launched in 2019 as half-priced versions of their main insulins — Lilly’s version of Humalog is known as insulin lispro, while Novo’s version of Novolog is named insulin aspart. It can get a bit confusing, because those two names are technically the scientific names of the particular insulins.

For this new offering, Walmart is simply buying Novolog insulin before it is packaged under that regulated product label, and instead labeling it as “ReliOn Novolog” to be sold exclusively at Walmart and its affiliate stores like Sam’s Club.

“This is considered a ‘private label’ approval and Walmart is a ‘private label distributor,’ which does not participate in the manufacture or processing of a drug but instead markets and distributes under its own trade name and labels a drug product made by someone else,” Novo’s Bachner told DiabetesMine.

So, you can see that the terminology is mired in technicality, but that doesn’t matter to most of us just trying to get our insulin at an affordable price.

Of course, the insulin pricing crisis has been raging for many years, so why is this just happening now?

Novo’s Bachner told DiabetesMine that the Pharma company has been discussing with Walmart the need to add an an analog insulin into its ReliOn program for a few years. The regulatory process for FDA approval took close to a year to complete.

“This announcement is certainly another important step in providing an array of affordability solutions for patients,” he said. “There’s no one single solution to help everyone, so we’re excited to be a part of another option to help patients.”

The announcement timing happened to coincide with the American Diabetes Association’s 2021 annual conference that ended June 29. While that provided an excellent PR platform, the timing is likely also due to the end of the second fiscal quarter ending in June 2021 that allowed both Walmart and Novo Nordisk to tout this news in its quarterly reports for investors.

Many in the Diabetes Community may wonder: Why not just lower the price of Novolog itself?

The frustrating answer is that insulin pricing is an overly “complicated” issue.

A lot of this is spelled out in research done over the past decade, from big organizations to industry analysis to state-level reports and Congressional hearings. In January 2021, a massive U.S. Senate committee report delved into this issue and laid out the many complicated moving parts that make drug pricing overall — and insulin pricing, in particular — tough to figure out.

Big Pharma companies like Eli Lilly, Novo Nordisk, and Sanofi manufacture the insulin brands, but there is a whole supply chain that typically stands between Pharma and the person using the insulin. Long before a patient shows up at the pharmacy counter to get their doctor-prescribed insulin, a whole chain of systematic cogs are turning — involving wholesalers and pharmacies, insurance companies and Pharmacy Benefit Managers (PBMs) who set formularies and require rebates and kickbacks.

There are a ton of “backroom” business dealings with contracts and money changing hands, and in the end even people without insurance coverage in the United States end up getting impacted by those negotiations.

It’s widely recognized that we have a broken drug pricing and healthcare system in America, and PWDs who need insulin face the consequences of that.

The big, established diabetes organizations have mostly applauded this move, while some more grassroots advocacy groups criticized it as more of a publicity grab than a real solution.

Both the JDRF and American Diabetes Association (ADA) offered statements praising the Walmart decision to offer this low-cost rapid-acting insulin, saying it gives PWDs another option to consider should they need help.

ADA Chief Executive Officer Tracey D. Brown pointed to the high costs of life with diabetes, which the organization estimates to be about $9,601 per person per year.

“We welcome all affordable solutions that make diabetes management more accessible to millions of Americans living with diabetes,” she said in a statement.

The JDRF emphasized that it’s been advocating for more affordability and predictable out-of-pocket costs of insulin for years and this is a positive change for some people. But it’s certainly not the end.

“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,” their statement said.

At the nonprofit Beyond Type 1, the organization’s chief advocacy officer Christel Marchand Aprigliano echoed those sentiments in a statement: “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.”

But the UK-based advocacy group T1International (T1I), that began the #insulin4all movement, sees this quite differently. “It will not stop needless deaths from rationing, because the cost is still far too high. Only legislative action to truly hold the industry accountable will be considered true progress,” said T1I founder Elizabeth Pfiester.

Adding to that, the group’s policy manager, Hilary Koch in Maine, tweeted: “Walmart insulin for $75? Even my 15-year-old figured out that this is 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.”

Across social media, many individual advocates are skeptical, too.

For example Chris Clem, who lives with type 1 diabetes in Utah, tweeted: “Is it just me, or is the Walmart Novolog announcement just a larger, still inadequate band-aid? $75 for a vial of insulin is a decision between rent/food or survival for many many people. It is still a 300 percent markup on the cost to make it. It’s life, not a luxury.”

No one denies that more needs to be done, including the insulin manufacturers.

Progress is happening, albeit slowly. There are state-level efforts to improve emergency access options and cap insulin copays for some people who have certain state-run health insurance plans. And there are continuing efforts to reform the rebate system and insurance coverage roadblocks that force people to use particular brands of insulin, strictly for business reasons.

And yes, there are some Band-Aid type resources for people in dire need to get financial assistance affording their medications. But they are quite restricted in what they do and who even can access those assistance programs.

The hope is to be able to one day soon cross a threshold that makes the notion of #insulin4all a reality we won’t have to continually fight for.