What is the cheapest insulin option for a Humana Medicare Advantage patient?

Cheapest Insulin Options for Humana Medicare Advantage Patients

Human regular insulin (such as Novolin R or ReliOn) available at Walmart for approximately $25 per vial is the cheapest insulin option for Humana Medicare Advantage patients. 1

Cost Comparison of Insulin Products

Lowest Cost Options

• Human regular insulin is available at some pharmacies (particularly Walmart) for approximately $25 per vial, making it the most affordable insulin option 1, 2
• NPH (Neutral Protamine Hagedorn) insulin is also available at similar low prices ($25-35 per vial) and can be used as an intermediate-acting insulin 1
• The median National Average Drug Acquisition Cost (NADAC) for human regular insulin is approximately $132 per 1,000 units for standard U-100 vials 1

Biosimilar/Follow-on Products (Mid-range Cost)

• Insulin glargine follow-on products like Basaglar have a median NADAC of approximately $95 per 1,000 units for vials, making them a more affordable long-acting option 1, 3
• Lispro follow-on products have a median NADAC of approximately $94 per 1,000 units for vials, making them a more affordable rapid-acting option 1

Higher Cost Options

• Brand-name rapid-acting insulin analogs (aspart, glulisine) have median NADACs of $140-277 per 1,000 units 1
• Long-acting insulin analogs like detemir (Levemir) and degludec (Tresiba) have median NADACs of $296-326 per 1,000 units 1, 3
• Concentrated insulin formulations (U-200, U-300, U-500) and insulin/GLP-1 RA combination products are the most expensive options 1

Clinical Considerations When Using Lower-Cost Insulins

Human Regular Insulin

• Has a slower onset (15 minutes) and longer duration (6-8 hours) compared to rapid-acting analogs 1
• Requires administration 30 minutes before meals for optimal effect 2
• May have higher risk of hypoglycemia compared to insulin analogs 4, 5

NPH Insulin

• Intermediate-acting insulin with onset of 1 hour, peak at 6-8 hours, and duration of 12 hours 1
• Requires consistent meal timing and content due to its peak action profile 1
• May have higher risk of nocturnal hypoglycemia compared to long-acting analogs 1, 6

Practical Approach for Medicare Advantage Patients

1. Start with human regular insulin for meal coverage (available for ~$25/vial) 1, 2
2. Add NPH insulin for basal coverage if needed (also available for ~$25-35/vial) 1
3. Consider premixed 70/30 formulations (70% NPH, 30% regular) if simplification is needed, also available at lower cost 1
4. Upgrade to insulin glargine follow-on products like Basaglar only if NPH causes problematic hypoglycemia 1, 3

Important Caveats and Considerations

• While insulin analogs may offer modest benefits in reducing hypoglycemia risk, these benefits may not justify the substantially higher costs for most patients 5, 6
• Medicare Part D has implemented a $35 monthly cap on insulin costs, which may affect out-of-pocket expenses regardless of the insulin chosen 1
• Patients should be educated about the different onset, peak, and duration profiles of human insulins compared to analogs to ensure safe and effective use 1
• For patients with frequent hypoglycemia on human insulins, the additional cost of analogs may be justified despite higher prices 4, 6