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Express Scripts won't cover Eli Lilly's new generic insulin

Insulin pens on an assembly line.
Insulin pens at an Eli Lilly plant in France. Photo: Frederick Florin/AFP via Getty Images

Eli Lilly's new "authorized generic" of its pricey Humalog insulin, called Lispro, is excluded from the 2019 national list of covered drugs from pharmacy benefit manager Express Scripts.

The big picture: So much for all the fanfare when Eli Lilly unveiled the insulin last month. Lispro's price doesn't change net spending on the insulin, even though it is cheaper for people paying cash out of pocket, and PBMs have little incentive to cover the drug if a rebate doesn't exist or is tiny.