New York-based health insurance provider Oscar Health has introduced a new drug formulary that will limit the cost for patients to just $3 per month for a supply of commonly used medicines. And the program includes some essential medications that have come under the spotlight for sky-high price hikes over the last several years, including insulin.
The announcement comes at a time when drug prices are still rising, with patients shouldering more cost- sharing responsibility. Insulin prices, in particular, have climbed drastically over the last several years, leaving some diabetic patients to ration their medication supplies or resort to extreme measures like traveling to neighboring countries to find cheaper medications.
The program mirrors Walmart’s launch of $4 generic prescriptions in 2006. However, Oscar’s new $3 offerings are not available in its biggest markets, including New York and New Jersey, as well as the company’s small group plans. Similarly, Walmart’s $4 generic prescriptions are limited. Only 50% of Oscar’s 420,000 members have access to the new program.
Oscar, which aims to set itself apart as a health insurer backed by innovative technology, launched the program at the start of the year and has already seen “increased utilization,” according to a press release. Specifically, the number of people using its insulin products has doubled compared to a year ago. Oscar is reviewing adding more brands to its list as a result.
“We looked at the most common therapeutic areas for our members––and, with clinician input, we picked drugs that had the best cost and clinical effectiveness,” Vinod Mitta, vice president of pharmaceuticals at Oscar, said in a statement. “We came up with a list of about a hundred drugs that represent 90% of the use cases that somebody might need a prescription for.”
Other healthcare companies are also looking at ways to help diabetes patients afford their insulin medications, which come in various products with different price points. Express Scripts also recently announced a $25 monthly cap on insulin and CVS Health offered a zero out-of-pocket program.
Oscar also recently partnered with Cigna to offer commercial health options to small businesses.
Editor's note: This article has been updated from a previous version that erroneously stated the new $3 drug pricing program is only available to 50% of Oscar’s market of individual plans. We regret the error.
Amy joined TriMed Media as a Senior Writer for HealthExec after covering home care for three years. When not writing about all things healthcare, she fulfills her lifelong dream of becoming a pirate by sailing in regattas and enjoying rum. Fun fact: she sailed 333 miles across Lake Michigan in the Chicago Yacht Club "Race to Mackinac."