UnitedHealthcare to End Copays for Some Drugs

Beginning in January 2023, UnitedHealthcare will eliminate out-of-pocket costs for some preferred prescription drugs. Patients in standard fully-insured group plans will now have a $0 copay for some short and long-acting insulins, as well as several drugs used to treat emergencies such as severe allergic reactions, hypoglycemia, opioid overdoses, and acute asthma attacks.

Brian Thompson

“We are doing what we can to shield people from the prices set by pharmaceutical companies and hope all stakeholders also will act to make prescription drugs more affordable,” Brian Thompson, chief executive officer of UnitedHealthcare, said in a press release.

In addition to insulin, four preferred emergency use medications will be included in the new standard offering and will also have a $0 cost share. These include:

• Epinephrine for severe allergic reactions
• Glucagon for hypoglycemia
• Naloxone for opioid overdoses
• Albuterol for acute asthma attacks

UnitedHealthcare is just one company that is beginning to offer some drugs at $0 copay. Recently, Elixir, a pharmacy services provider that is a subsidiary of Rite Aid, launched a specialty generic medication that allows members to receive generic versions of certain specialty medications at a $0 copay with no extra charge to the plan. Effective June 1, 2022, this program includes 28 generic medications for complex medical conditions that are high-dollar and high-touch such as medications for oncology, multiple sclerosis, neurologic and respiratory conditions.

Related: Elixir Launches Specialty Generic Program

These moves come after greater scrutiny of patient copays and drug pricing overall. The out-of-pocket costs patients pay for insulin, especially, have become a target in efforts to control costs. Congress and President Joseph Biden have been focused on putting forth legislation that caps out-of-pocket costs for insulin at $35.

The political momentum to cap insulin prices comes as out-of-pocket prices for the medication continue to be high and are rising. The average cash price for insulins climbed approximately 55% from 2014 to 2019, from $0.22 to $0.34 per insulin unit, according to GoodRx (an insulin unit is a measure used for dosing.)

Walmart and Civica Rx are taking steps that could make less expensive versions of the diabetes medication more available. And some drugmakers have made efforts to blunt the criticism about insulin prices. For example, Sanofi announced in late June that it would limit its insulin prices to $35 per month for people without health insurance.

Sanofi Lowers Insulin Price

The costs of insulins when paid without insurance are more than $142 per month, according to IQVIA Institute for Human Data Sciences’ most recent Use of Medicines report. Even for those with insurance, patients pay more than $35 a month for insulin 22% of the time.

Across all medicines, patients abandon 46% of new prescriptions that cost them from $125 to $249.99; patients abandon 61% of prescription that cost more than $250.