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Getting Insulin During COVID-19

By Karena Yan

Make sure that you have, and are able to access, insulin during the coronavirus pandemic. Here are tips to stay prepared

People with diabetes are not necessarily at a higher risk of contracting COVID-19. However, your immune system (which runs your body’s ability to fight off viruses like COVID-19) is weakened when your blood sugars run too high for long periods of time. That’s why it is especially important to carefully manage your blood glucose levels during this pandemic. To do so, make sure that you have and are able to access as much insulin as you need.

As we understand it, global supply chains for most diabetes medications, including insulin, are currently working as expected, and there is no cause for alarm on the supply front at this stage. However, here is what you can do to be prepared, to better afford insulin, and to respond to a sudden need for more insulin.

What can I do to stay prepared?

1. Call your doctor to make sure all your prescriptions are current and that you have the maximum number of refills that you are allowed.

This includes insulin, oral drugs you take to manage blood sugar, and any related supplies, such as: syringes or pens, insulin pump supplies, pen needles, glucose strips, lancets, alcohol swabs, ketone strips, glucagon or other things you use to manage your diabetes.

Several factors – including your specific insurance plan, laws, and the type of medication – determine the amount of prescriptions and supplies you can get from your pharmacy at a time.

2. Check your insurer’s website or contact your local pharmacy to learn about any changes to your prescription refill policy.

Several insurance companies have released statements about emergency prescription refill allowances:

  • BlueCross BlueShield has announced a national COVID-19 coverage plan, including "waiving early medication refill limits on 30-day prescriptions [...] and/or encouraging members to use their 90-day mail order benefit."

  • Aetna is providing 90-day prescription medications to its members and to people on Medicare.

  • Anthem is changing its 30-day refill limits for some medications and encouraging members to ask their doctors for 90-day prescriptions. 

  • UnitedHealthcare members can fill prescriptions early (for a 90-day supply) at their pharmacy or through mail order, and many prior authorization requirements have been paused.

  • Regence BlueCross BlueShield announced that they are easing refill restrictions for non-opioid medications, allowing 90-day prescription refills in Washington, Utah, and Oregon.

Numerous states, including Colorado, Florida, Maryland, and Washington, have also issued emergency orders that grant prescription refill waivers for certain critical medications, including insulin. These waivers allow pharmacists to refill prescriptions early. Healthcare Ready provides a list of current state-level emergency orders, and it advises people to follow their local health department on social media for updates about prescription refills.

3. Sign up for a prescription mail-order service.

A mail-order prescription is delivered straight to your doorstep. Not only will this allow you to stay home and stay safe, but it may also allow you to receive a larger supply of medications. Mail-order pharmacies operate through your health plan and usually contain a 90-day bulk supply, compared to the typical 30-day supply filled at a local pharmacy. Receiving medications in bulk can also save you money.

Many mail-order pharmacies also offer 24/7 support services through their website or by telephone. This is helpful for getting your questions answered without having to travel to the pharmacy and speak to someone in person.

To set up mail-order prescriptions, visit your insurance company’s website. Here are the mail-order pharmacy websites for some common health insurers in the United States:

What programs can help me get and afford insulin?

Lilly introduced their new Lilly Insulin Value Program on April 7, which allows anyone who has commercial insurance, or no insurance, to purchase their monthly prescription of Lilly insulin for $35. This program covers most Lilly insulins, including Humalog and non-branded insulins. To access this program's copay card, call the Lilly Diabetes Solution Center at 1-833-808-1234 between 8 a.m. to 8 p.m. Eastern time, Monday through Friday. Those who currently have a Lilly co-pay card do not need to take any action – active cards have already been reset to a $35 copay. 

Novo Nordisk announced that people who have lost health insurance due to a change in employment status during COVID-19 may be eligible for Novo Nordisk’s Patient Assistance Program to receive free insulin for 90 days. To qualify for the program, applicants must provide documents showing a loss of healthcare benefits (such as a job termination notice, job status change, or proof that COBRA benefits are being offered). Find out if you meet eligibility criteria at NovoCare.com or by calling 1-844-NOVO4ME (1-844-668-6463). 

Sanofi insulin users may call 1-888-847-4877 to speak to a representative about financial challenges and how to get the medicines and resources you need.

All three insulin manufacturers – Lilly, Novo Nordisk, and Sanofi – also have patient assistance programs and prescription savings cards in place to help people with diabetes afford insulin.

1. Patient assistance programs provide free insulin for people who are uninsured and meet income eligibility requirements:

2. Copay savings cards help reduce out-of-pocket costs of medications. If you qualify, you can use these cards at the pharmacy counter to receive discounts on your medication:

For a full list of copay assistance programs, please see our Paying for Insulin resource page.

All three insulin manufacturers – Lilly, Novo Nordisk, and Sanofi – have released public statements about their supply chains, assuring consumers that COVID-19 has not disrupted their insulin manufacturing or distribution and that they are not expecting shortages. However, because of recent increased orders, some U.S. pharmacies may be temporarily out of stock. If your pharmacy does not have your insulin in stock, ask your pharmacist to request an order from their wholesaler. It’s important to plan ahead and try to get your insulin refilled at least two weeks before it runs out.

What do I do if I run out of insulin?

If you are in urgent need of insulin, several options may provide immediate relief.

  • At Walmart, you can buy insulin for $25 without a prescription (“over-the-counter”) and without insurance. It comes in a 10mL vial and is called Novolin ReliOn Insulin. It is offered in both regular human insulin (“R” – for use at mealtime) and NPH (“N” – a longer-acting basal insulin). You can also get Novolin at a CVS Pharmacy for $25 per 10mL vial through the Reduced Rx program. It takes little time to enter your email and receive a discount card (which you can print or show digitally) that you can use immediately at 67,000 participating pharmacies nationwide, including those at CVS Pharmacy, Walgreens, and Walmart.

    • Note that NPH and regular insulins work differently from analog insulins: 

      • NPH lowers blood glucose over a period of more than 12 hours (its “duration of action”), and its peak glucose-lowering effect is at 4-6 hours. 

      • Regular insulin lowers blood glucose over a period of 6-8 hours. It peaks around 2-4 hours, and it is best taken 15 minutes before eating.

    • Because of these differences, be sure to discuss your decision with a healthcare professional before changing to one of these insulins.

  • Visit a community health clinic or pharmacy in your area that can help you access insulin at a reduced cost. These sites provide treatment regardless of insurance coverage and have a sliding scale payment option, which means your medical cost is related to your income. 

  • Call 1-800-DIABETES to speak to an American Diabetes Association representative to learn more about your options. Representatives are available Monday–Friday, 9am to 7pm ET. They can connect you with resources in your area and can answer questions in English, Spanish, or any language with a language interpreter service. (Please note that ADA representatives can only answer non-medical questions. If you are in need of emergency medical service, call 911.)

This article is part of a series on access that was made possible by support from Sanofi. The diaTribe Foundation retains strict editorial independence for all content. 

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