Reality check on Lilly's new, cheaper insulin

Eli Lilly’s decision to start selling a new version of its most popular fast-acting insulin highlights the industry’s concerns about possible legislation or regulation to rein in drug prices.

Reality check: Some diabetic patients will benefit from Lilly's new authorized generic, called Lispro. But the PR-heavy move, which has been replicated for other controversially priced medicines, isn't structural change. It aligns with the Trump administration's goal of lowering prices at the pharmacy counter — not necessarily what the system overall pays.

By the numbers: Humalog, which generated $3 billion of revenue for Lilly in 2018, has a list price of $275 per vial. Lispro’s list price will be half that.

Yes, but: A Lilly spokesperson confirmed that Lispro's price will be "comparable" to what Humalog costs after accounting for rebates and discounts.

• There's no guarantee health insurers or pharmacy benefit managers will cover Lispro, and it's highly unlikely Lilly will offer sizable rebates, if any, for this insulin product.
• A spokesperson said the company is "not able to comment or speculate on what the rebates will be."

We’ve seen this movie before.

• Mylan created an authorized generic for its EpiPens in 2016.
• Gilead created authorized generics for its hepatitis C medications last year.
• Releasing authorized generics allows companies to compete with themselves, which benefits them more than cutting the price of the brand-name drug.

The bottom line: Lilly's generic insulin will help people with diabetes who don't have insurance, or who face high deductibles and coinsurance rates.

• But it will not fundamentally change what the country pays for this kind of insulin — or others versions of insulin.
• Patient advocates who have diabetes pointed out that at $140 per vial, Lispro will still cost 7 times as much as the same insulin in other developed countries.

Go deeper: Axios' special report on drug pricing