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How we price our medicines is not a decision we take lightly or one we make in isolation.
We consider how a patient can access the medicine, and the impact that access may have across the varying and unique healthcare systems around the world.
We seek to strike the balance between access and sustaining an industry that can continue to build upon the lifechanging treatments it has discovered for some of our most serious diseases.
This is one of the most important decisions we make as a company.
Lilly continues to work to expand access to medicines in the U.S. healthcare system—by helping consumers, communities, and our employees; by providing greater transparency about how our products are priced; and through the policies we promote.
We strike a balance between access and affordability for patients while sustaining investments in life-changing treatments for some of today’s most serious diseases.
We consider: Lilly sets a list price for our medicines.
To enable patient access, Lilly pays rebates and other discounts to payers and other supply chain entities.
The final amount that Lilly ultimately realizes after paying these rebates and discounts is sometimes called the net price.
Across our U.S. product portfolio, Lilly’s average net price after rebates and discounts—the final amount we receive—has fallen from in 2018.
The amount of Lilly’s rebates and discounts continues to increase through a combination of factors— including increased market competition, pharmacy benefit managers’ (PBMs’) increased negotiation leverage, and rising mandatory government discounts.
However, changes in insurance design and the trend toward greater consumer cost-sharing (through highdeductible plans and co-insurance) means a growing number of patients are exposed to medicines’ full retail price at the pharmacy.
AFTER DISCOUNTS ACROSS THE U.S. PRODUCT PORTFOLIO 20182017201620152014 59% 55% 50% 49% 46% deliver greater economic and health value to healthcare systems.
In addition, Lilly has a longstanding policy of not seeking or enforcing patents for medicines in any of the least developed countries, as defined by the United Nations.
The average net price percentage is calculated by dividing net sales, the amount Lilly receives after discounts (rebates and channel cost), by the annual gross sales (total sales at list price, prior to all discounts).
used presentation of Humalog (Source: IQVIA LAAD Data 2014-2018).
In would have consumed approximately 19 MLs of insulin per month; this equates to approximately 2 vials or 6.4 Kwikpens.
The actual utilization per patient per month may differ significantly depending on multiple factors, including prescription amounts and adherence behaviors.
marketed in the United States for which Lilly is the holder of the new drug application (NDA).
4. List price represents the weighted average year-over-year change in the wholesale acquisition cost (WAC).
Net price represents weighted average year-over-year change in net price, which is WAC minus rebates, discounts, and channel costs.
Humalog U100 is the most broadly used Lilly insulin product.
The last list price increase for Humalog U100 was May 2017.
The net price in the chart represents the average revenue Lilly realized per patient per month for Humalog Utaken as prescribed.
Between increased 51.9% while the average amount that Lilly received – the net price – declined by 8.1%.
Lilly works with all parts of the healthcare system to find solutions that make medicines more accessible and affordable.
We support improvements to the U.S. healthcare system that appropriately balance patient affordability, market-based competition, and rewarding innovation.
We advocate for policy changes at the state and federal level to improve patient affordability, such as exempting treatments for chronic diseases from patient deductibles and passing through rebates to patients at the point of sale.
In this spirit, Lilly implemented a number of solutions in 2018 that support patients and our employees.
These are positive steps, but we know there is more to do, and that is why we are committed to finding more solutions to lower the out-of-pocket costs for medicine at the pharmacy counter.
We don’t want anyone to have to pay full list price for their insulin, and many people who do will be able to pay significantly less by calling our helpline.
Lilly recognizes that some people may struggle to pay for their medicines.
We are committed to finding solutions to lower out-of-pocket costs and to implement other changes that can help the U.S. health system work better for patients.
50 percent lower than the current Humalog list price.
REDUCING COSTS AND IMPROVING HEALTH FOR EMPLOYEES AT LILLY Employers can play a key role in patient access and affordability by offering benefits that help reduce employee medical costs.
Lilly applies prescription drug rebates at the point of sale to help our employees, retirees, and their families with out-of-pocket medicine costs.
Last year, more than rebates, reducing their costs by approximately $3 million.
We also use rebates to reduce the cost of medical coverage premiums.
We exempt preventive and chronic disease medications from the deductible of our employees’ health plans to ensure there are no barriers for accessing medicines critical to their overall health and well-being.
Starting in eligible employees and their family members living with diabetes a free connected glucose meter and related supplies, along with real-time support from trained diabetes educators.
In patient-focused helpline—opened to help identify ways patients can access the Lilly insulin they need.
Staffed with representatives who take a personalized approach, the confidential helpline is available to residents throughout the United States and all U.S. territories, and features representatives who speak English, Spanish, and several other languages.
People in the United States can reach the Lilly Diabetes Solution Center by calling 1-833808-1234.
As of early month received help through the center.
In March Lilly announced a lower-priced version of Humalog called Insulin Lispro.
This authorized generic version—which is identical to Humalog—is offered at a list price lower than the current Humalog list price.
The center is offering a suite of solutions—some of which are being offered for the first time—that can significantly lower and cap high monthly out-of-pocket costs for some people who use Lilly insulins.
Dedicated representatives will review the personal circumstances and identify options for people who pay near the full list price, such as the uninsured and people in the deductible phase of their high-deductible insurance plans, as well as potential solutions for people with lower incomes.
The following solutions are available through the helpline: Point-of-Sale Savings Helpline representatives can advise callers who face the highest out-of-pocket costs at the pharmacy, such as people who are uninsured and people in the deductible phase of their high-deductible commercial insurance plans.
The amount of cost reduction varies person-toperson based upon individual circumstances.
Out-ofpocket costs for people who use traditional co-pay or co-insurance plans will continue to be set by their health insurer, and federal regulations prevent people who use Medicare Part D or other federal programs from obtaining additional point-of-sale savings.
Free Clinics Lilly is donating insulin to three relief agencies— Americares, Direct Relief, and Dispensary of Hope—to supply nearly with Lilly insulin.
Helpline representatives point people toward clinics that are most convenient to them and provide information about how to obtain insulin at those locations.
Lilly is working with these relief agencies to identify as many clinics as possible that can adequately store and distribute insulin to people who need it.
Immediate Needs for Insulin If someone has an immediate need for insulin, they can also call the Lilly Diabetes Solution Center to learn about immediate as well as longer-term options.
A G E Lilly 30x30 To accelerate our global health efforts, we established Lilly 30x30—a bold goal to increase access to quality health care in communities with limited resources for 30 million people on an annual basis by 2030.
Lilly is a companywide effort through which we use a mix of shared value and philanthropic approaches, often in collaboration with partners, to achieve our goal.
FOCUS AREAS Lilly areas: partnerships, programs, and pipeline.
In each of these three key areas, we are leading cross-functional teams to develop, pilot, and measure high-impact, scalable projects.
Lilly medicines Pipeline - Discovering new medicines and exploring our current portfolio and shelved assets to find new indications for diseases that disproportionately affect people in resource-limited settings Lilly has formed a steering committee to manage progress toward the 30x30 goal.
As a leading biopharmaceutical company, Lilly has an important role to play in improving access to quality health care for people living in communities with limited resources.
We are committed to extending the Lilly promise of caring and discovery to millions more people around the world.
Our global health efforts focus on people who aren’t typically reached by our traditional business operations.
We use a mix of philanthropy and shared value-based approaches, and concentrate on diseases where we have deep technical expertise, including diabetes and cancer, partnering with leading experts and organizations to expand our reach.
A G E Partnerships Through strategic partnerships providing support and funding, Lilly and the Eli Lilly and Company Foundation, a separate, independent, nonprofit organization, work to advance government priorities, strengthen local healthcare systems, and improve access to care.
Lilly uses its technology and expertise in collaborations with other organizations to find innovative, sustainable, and scalable approaches and solutions to pressing global health concerns, including diabetes and cancer.
GLOBAL HEALTH PARTNERSHIP The Lilly Global Health Partnership advances more than improve access and care.
Under new leadership and with increased strategic focus in on developing collaborations with a variety of partners to expand access to quality care for people living in resource-limited settings.
We use our Research, Report, and Advocate framework to measure and evaluate effectiveness of our partnership and reach the greatest number of people.
Lilly Global Health Partnership Focus Areas Working with expert partners, the Lilly Global Health Partnership helps people living in limited-resource settings, with a focus on five countries.
G O A L S Lilly partners with local institutions around the world to pilot and extend the reach of effective health programs.
Using the data that we collect, we advocate for the scaling up of interventions that show the greatest impact.
We also advocate for the increased prioritization of non-communicable diseases (NCDs)—including cardiovascular diseases, cancer, diabetes, and mental health conditions—on the health agenda at the global and national levels.
Lilly is also a member of the NCD Alliance, a global thought leader that brings the voice of communities and civil society to policy and practice related to NCDs.
Lilly participates in Access Accelerated, a first-of-itskind, industry-driven collaboration focused on improving NCD care through new models of partnerships and multistakeholder engagement.
For more than providing support and funding to help AMPATH provide medicines and quality health care to people living in western Kenya.
The growing partnership has played an important role in helping AMPATH build Kenya’s first system of sustainable care for the communities it serves—services that would otherwise be out of reach for the many people there who live on less than $a day.
In 2018, Lilly donated nearly $24 million in medicines to AMPATH.
AMPATH, which stands for Academic Model Providing Access to Healthcare, was created in epidemic in western Kenya.
AMPATH has continually expanded its successful approach in treating HIV/ AIDS (including diagnosis, treatment, and patient support) to more diseases, including diabetes, hypertension, and cancer.
Today, AMPATH serves a population of more than sites—from village health centers and dispensaries, to county hospitals, to the Moi Teaching and Referral Hospital in Eldoret, where the organization is headquartered.
To date, AMPATH has trained professional and community health workers, building local knowledge and service capacity.
Support and funding from Lilly and the Lilly Foundation—along with numerous other organizations and individuals—are allowing AMPATH to screen, treat, and provide palliative care to more people than ever before.
Part of this vital support is directed to AMPATH’s Oncology Institute, which opened in in an alley behind AMPATH’s main building.
Public-private partnerships, including Lilly’s support with a $four years, have allowed the institute to expand into a permanent facility, including 14 additional clinics and numerous oncology-trained clinicians.
In 2018, the institute received more than 10,000 patient visits.
But demand far outstrips supply: the institute is one of only two cancer centers in Kenya, meaning that nearly half of the country’s screening and care.
To help address this gap, the Lilly Foundation committed an additional $cervical cancer screenings.
Lilly also sends employees to volunteer with AMPATH through the company’s Connecting Hearts Abroad program.
Employees help support AMPATH’s mobile screening efforts that reach people like Nancy Odari.
Since to AMPATH, helping to dramatically reduce what were once frequent shortages of medicines that resulted in people being turned away from clinics.
Within the health system, AMPATH and Lilly have worked with the Kenyan government to develop innovative solutions to improve the overall donation process, minimize delays, and improve the availability of muchneeded medicines.
This includes the creation of a novel system which helps ensure that donated medicines will be available on a sustainable basis after government supplies are depleted.
The model was first used for Lilly insulin, and helped to improve the availability of the medicine from 30 percent to 90 percent in western Kenya.
This subsidized, but incentivized, pharmacy model has since been expanded to include most essential medicines, with similarly strong results.
—Nancy Odari is all of these and more.
“I want to encourage people to know that having cancer is not the end of life.
Nancy received early diagnosis and treatment for breast cancer thanks to community health screenings through AMPATH, Lilly’s global health partner in Kenya.
Through product and financial donations, Lilly and the Lilly Foundation support the AMPATH consortium, including the launch of AMPATH’s oncology center and mobile screening program for breast and cervical cancer.
Today, Nancy helps others get screening for early detection.

How we price our medicines is not a decision we take lightly or one we make in isolation.

We consider how a patient can access the medicine, and the impact that access may have across the varying and unique healthcare systems around the world.

We seek to strike the balance between access and sustaining an industry that can continue to build upon the lifechanging treatments it has discovered for some of our most serious diseases.

This is one of the most important decisions we make as a company.

Lilly continues to work to expand access to medicines in the U.S. healthcare system—by helping consumers, communities, and our employees; by providing greater transparency about how our products are priced; and through the policies we promote.

We strike a balance between access and affordability for patients while sustaining investments in life-changing treatments for some of today’s most serious diseases.

We consider: Lilly sets a list price for our medicines.

To enable patient access, Lilly pays rebates and other discounts to payers and other supply chain entities.

The final amount that Lilly ultimately realizes after paying these rebates and discounts is sometimes called the net price.

Across our U.S. product portfolio, Lilly’s average net price after rebates and discounts—the final amount we receive—has fallen from in 2018.

The amount of Lilly’s rebates and discounts continues to increase through a combination of factors— including increased market competition, pharmacy benefit managers’ (PBMs’) increased negotiation leverage, and rising mandatory government discounts.

However, changes in insurance design and the trend toward greater consumer cost-sharing (through highdeductible plans and co-insurance) means a growing number of patients are exposed to medicines’ full retail price at the pharmacy.

AFTER DISCOUNTS ACROSS THE U.S. PRODUCT PORTFOLIO 20182017201620152014 59% 55% 50% 49% 46% deliver greater economic and health value to healthcare systems.

In addition, Lilly has a longstanding policy of not seeking or enforcing patents for medicines in any of the least developed countries, as defined by the United Nations.

The average net price percentage is calculated by dividing net sales, the amount Lilly receives after discounts (rebates and channel cost), by the annual gross sales (total sales at list price, prior to all discounts).

used presentation of Humalog (Source: IQVIA LAAD Data 2014-2018).

In would have consumed approximately 19 MLs of insulin per month; this equates to approximately 2 vials or 6.4 Kwikpens.

The actual utilization per patient per month may differ significantly depending on multiple factors, including prescription amounts and adherence behaviors.

marketed in the United States for which Lilly is the holder of the new drug application (NDA).

4. List price represents the weighted average year-over-year change in the wholesale acquisition cost (WAC).

Net price represents weighted average year-over-year change in net price, which is WAC minus rebates, discounts, and channel costs.

Humalog U100 is the most broadly used Lilly insulin product.

The last list price increase for Humalog U100 was May 2017.

The net price in the chart represents the average revenue Lilly realized per patient per month for Humalog Utaken as prescribed.

Between increased 51.9% while the average amount that Lilly received – the net price – declined by 8.1%.

Lilly works with all parts of the healthcare system to find solutions that make medicines more accessible and affordable.

We support improvements to the U.S. healthcare system that appropriately balance patient affordability, market-based competition, and rewarding innovation.

We advocate for policy changes at the state and federal level to improve patient affordability, such as exempting treatments for chronic diseases from patient deductibles and passing through rebates to patients at the point of sale.

In this spirit, Lilly implemented a number of solutions in 2018 that support patients and our employees.

These are positive steps, but we know there is more to do, and that is why we are committed to finding more solutions to lower the out-of-pocket costs for medicine at the pharmacy counter.

We don’t want anyone to have to pay full list price for their insulin, and many people who do will be able to pay significantly less by calling our helpline.

Lilly recognizes that some people may struggle to pay for their medicines.

We are committed to finding solutions to lower out-of-pocket costs and to implement other changes that can help the U.S. health system work better for patients.

50 percent lower than the current Humalog list price.

REDUCING COSTS AND IMPROVING HEALTH FOR EMPLOYEES AT LILLY Employers can play a key role in patient access and affordability by offering benefits that help reduce employee medical costs.

Lilly applies prescription drug rebates at the point of sale to help our employees, retirees, and their families with out-of-pocket medicine costs.

Last year, more than rebates, reducing their costs by approximately $3 million.

We also use rebates to reduce the cost of medical coverage premiums.

We exempt preventive and chronic disease medications from the deductible of our employees’ health plans to ensure there are no barriers for accessing medicines critical to their overall health and well-being.

Starting in eligible employees and their family members living with diabetes a free connected glucose meter and related supplies, along with real-time support from trained diabetes educators.

In patient-focused helpline—opened to help identify ways patients can access the Lilly insulin they need.

Staffed with representatives who take a personalized approach, the confidential helpline is available to residents throughout the United States and all U.S. territories, and features representatives who speak English, Spanish, and several other languages.

People in the United States can reach the Lilly Diabetes Solution Center by calling 1-833808-1234.

As of early month received help through the center.

In March Lilly announced a lower-priced version of Humalog called Insulin Lispro.

This authorized generic version—which is identical to Humalog—is offered at a list price lower than the current Humalog list price.

The center is offering a suite of solutions—some of which are being offered for the first time—that can significantly lower and cap high monthly out-of-pocket costs for some people who use Lilly insulins.

Dedicated representatives will review the personal circumstances and identify options for people who pay near the full list price, such as the uninsured and people in the deductible phase of their high-deductible insurance plans, as well as potential solutions for people with lower incomes.

The following solutions are available through the helpline: Point-of-Sale Savings Helpline representatives can advise callers who face the highest out-of-pocket costs at the pharmacy, such as people who are uninsured and people in the deductible phase of their high-deductible commercial insurance plans.

The amount of cost reduction varies person-toperson based upon individual circumstances.

Out-ofpocket costs for people who use traditional co-pay or co-insurance plans will continue to be set by their health insurer, and federal regulations prevent people who use Medicare Part D or other federal programs from obtaining additional point-of-sale savings.

Free Clinics Lilly is donating insulin to three relief agencies— Americares, Direct Relief, and Dispensary of Hope—to supply nearly with Lilly insulin.

Helpline representatives point people toward clinics that are most convenient to them and provide information about how to obtain insulin at those locations.

Lilly is working with these relief agencies to identify as many clinics as possible that can adequately store and distribute insulin to people who need it.

Immediate Needs for Insulin If someone has an immediate need for insulin, they can also call the Lilly Diabetes Solution Center to learn about immediate as well as longer-term options.

A G E Lilly 30x30 To accelerate our global health efforts, we established Lilly 30x30—a bold goal to increase access to quality health care in communities with limited resources for 30 million people on an annual basis by 2030.

Lilly is a companywide effort through which we use a mix of shared value and philanthropic approaches, often in collaboration with partners, to achieve our goal.

FOCUS AREAS Lilly areas: partnerships, programs, and pipeline.

In each of these three key areas, we are leading cross-functional teams to develop, pilot, and measure high-impact, scalable projects.

Lilly medicines Pipeline - Discovering new medicines and exploring our current portfolio and shelved assets to find new indications for diseases that disproportionately affect people in resource-limited settings Lilly has formed a steering committee to manage progress toward the 30x30 goal.

As a leading biopharmaceutical company, Lilly has an important role to play in improving access to quality health care for people living in communities with limited resources.

We are committed to extending the Lilly promise of caring and discovery to millions more people around the world.

Our global health efforts focus on people who aren’t typically reached by our traditional business operations.

We use a mix of philanthropy and shared value-based approaches, and concentrate on diseases where we have deep technical expertise, including diabetes and cancer, partnering with leading experts and organizations to expand our reach.

A G E Partnerships Through strategic partnerships providing support and funding, Lilly and the Eli Lilly and Company Foundation, a separate, independent, nonprofit organization, work to advance government priorities, strengthen local healthcare systems, and improve access to care.

Lilly uses its technology and expertise in collaborations with other organizations to find innovative, sustainable, and scalable approaches and solutions to pressing global health concerns, including diabetes and cancer.

GLOBAL HEALTH PARTNERSHIP The Lilly Global Health Partnership advances more than improve access and care.

Under new leadership and with increased strategic focus in on developing collaborations with a variety of partners to expand access to quality care for people living in resource-limited settings.

We use our Research, Report, and Advocate framework to measure and evaluate effectiveness of our partnership and reach the greatest number of people.

Lilly Global Health Partnership Focus Areas Working with expert partners, the Lilly Global Health Partnership helps people living in limited-resource settings, with a focus on five countries.

G O A L S Lilly partners with local institutions around the world to pilot and extend the reach of effective health programs.

Using the data that we collect, we advocate for the scaling up of interventions that show the greatest impact.

We also advocate for the increased prioritization of non-communicable diseases (NCDs)—including cardiovascular diseases, cancer, diabetes, and mental health conditions—on the health agenda at the global and national levels.

Lilly is also a member of the NCD Alliance, a global thought leader that brings the voice of communities and civil society to policy and practice related to NCDs.

Lilly participates in Access Accelerated, a first-of-itskind, industry-driven collaboration focused on improving NCD care through new models of partnerships and multistakeholder engagement.

For more than providing support and funding to help AMPATH provide medicines and quality health care to people living in western Kenya.

The growing partnership has played an important role in helping AMPATH build Kenya’s first system of sustainable care for the communities it serves—services that would otherwise be out of reach for the many people there who live on less than $a day.

In 2018, Lilly donated nearly $24 million in medicines to AMPATH.

AMPATH, which stands for Academic Model Providing Access to Healthcare, was created in epidemic in western Kenya.

AMPATH has continually expanded its successful approach in treating HIV/ AIDS (including diagnosis, treatment, and patient support) to more diseases, including diabetes, hypertension, and cancer.

Today, AMPATH serves a population of more than sites—from village health centers and dispensaries, to county hospitals, to the Moi Teaching and Referral Hospital in Eldoret, where the organization is headquartered.

To date, AMPATH has trained professional and community health workers, building local knowledge and service capacity.

Support and funding from Lilly and the Lilly Foundation—along with numerous other organizations and individuals—are allowing AMPATH to screen, treat, and provide palliative care to more people than ever before.

Part of this vital support is directed to AMPATH’s Oncology Institute, which opened in in an alley behind AMPATH’s main building.

Public-private partnerships, including Lilly’s support with a $four years, have allowed the institute to expand into a permanent facility, including 14 additional clinics and numerous oncology-trained clinicians.

In 2018, the institute received more than 10,000 patient visits.

But demand far outstrips supply: the institute is one of only two cancer centers in Kenya, meaning that nearly half of the country’s screening and care.

To help address this gap, the Lilly Foundation committed an additional $cervical cancer screenings.

Lilly also sends employees to volunteer with AMPATH through the company’s Connecting Hearts Abroad program.

Employees help support AMPATH’s mobile screening efforts that reach people like Nancy Odari.

Since to AMPATH, helping to dramatically reduce what were once frequent shortages of medicines that resulted in people being turned away from clinics.

Within the health system, AMPATH and Lilly have worked with the Kenyan government to develop innovative solutions to improve the overall donation process, minimize delays, and improve the availability of muchneeded medicines.

This includes the creation of a novel system which helps ensure that donated medicines will be available on a sustainable basis after government supplies are depleted.

The model was first used for Lilly insulin, and helped to improve the availability of the medicine from 30 percent to 90 percent in western Kenya.

This subsidized, but incentivized, pharmacy model has since been expanded to include most essential medicines, with similarly strong results.

—Nancy Odari is all of these and more.

“I want to encourage people to know that having cancer is not the end of life.

Nancy received early diagnosis and treatment for breast cancer thanks to community health screenings through AMPATH, Lilly’s global health partner in Kenya.

Through product and financial donations, Lilly and the Lilly Foundation support the AMPATH consortium, including the launch of AMPATH’s oncology center and mobile screening program for breast and cervical cancer.

Today, Nancy helps others get screening for early detection.