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Drew Blankenship

Why Your Insulin Price Could Change Even When Your Insurance Plan Doesn’t

insulin price
Your insulin price can change even if your insurance plan doesn’t. Formulary updates, PBM negotiations, and manufacturer agreements often affect what you pay at the pharmacy. Pixel-Shot/Shutterstock

Before he died, my father had a rough battle with diabetes. Managing the disease is challenging enough without being surprised by a higher pharmacy bill, or worse yet, a medication you can’t even afford. Yet many people discover that the amount they pay for insulin changes even though they haven’t switched employers, changed insurance companies, or selected a new health plan. That can leave patients wondering whether a mistake was made or if their insurance suddenly stopped covering their medication.

Insulin prices can change because of behind-the-scenes updates involving pharmacy benefit managers (PBMs), formularies, manufacturer discounts, and annual contract negotiations, not necessarily because your insurance changed. Here is why the price of your insulin may have changed (even if nothing else did).

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