Full statement from Novo Nordisk

Re the price of insulin:

List prices are a function of the system in which we operate. We are part of a system where
prices are rising in every sector of the US healthcare market. We set list prices based on a
variety of factors, including the competitive environment, which includes constant demands
by PBMs for rebates for formulary access. If we don’t provide the rebates we may not get
on or stay on the PBM formulary – and if we’re not on the formulary doctors and patients
may not get access to our medicine. At the same time, insurers and employers are putting
pressure on PBMs to lower their premiums.

As a company, we believe that doctors should be able to choose the medicine that best suits
their patients. We are committed to finding solutions that lower out-of-pocket costs for
patients and ensure that rebates and discounts are passed through to the patients who
need them to afford their medicines.

Should the system be changed?

We, and most others in the healthcare system, agree that what we currently have needs to
change. We appreciate discussions with the Administration and legislatures to find long-
term ways to reduce the burdens for patients. To be fair and sustainable, a new system
should decrease the burden of buying medicine for all patients, work effectively within the
broader healthcare system and provide appropriate incentives for developing new and
better therapies.

Already one change has occurred: We’re very pleased that the US Treasury Department and
the IRS expanded the list of preventive care benefits permitted to be provided by a high
deductible health plan (HDHP) without a deductible, or with a deductible below the
applicable minimum deductible (self-only or family) for an HDHP. Insulin is officially a
preventive medicine.

This became effective July 17, 2019. Now all health plans have an opportunity to make this
vital medicine available at reasonable costs for those worried about paying list price while
working through their deductible. This is good news as it’s an example of the healthcare
system working to address insulin affordability challenges. However, the next step is for
plans to add insulins and other diabetes medications to their preventive drug lists as a
standard offering.

Assistance to people who need help:

Novo Nordisk offers to help people with diabetes through:

  A Patient Assistance Program (PAP) that Novo Nordisk has offered since 2003.
The PAP provides free medicines, including all Novo Nordisk insulins, to eligible
patients who do not have insurance; Medicare patients who incur high costs while in
the Part D coverage gap or who do not have Part D coverage and have been denied
the Extra-Help/Low-Income subsidy; and patients who are Medicaid eligible but have
been denied Medicaid. A family of four with an annual income up to $103,000 may
receive free medications through our PAP. For individuals, the annual income limit for
participation is $49,960. In 2018, nearly 50,000 Americans received free insulin from
Novo Nordisk through this program.
• Novo Nordisk human insulin that has been available at Walmart for about
$25/vial for 15 years. In 2017, we partnered with CVS Health and other national
pharmacies to expand the $25 human insulin offering to tens of thousands of
pharmacies nationwide. In 2018, we provided human insulin in a convenient pen
injection device through Walmart. We estimate that about 500,000 Americans are
using Novo Nordisk human insulin through these partnerships.
• Co-pay Savings Cards to help defray the costs of commercially insured patients
who are experiencing high out-of-pocket costs. In 2018, Novo Nordisk provided more
than $200 million in assistance to patients through coupons and co-pay cards.

And starting January 2, 2020, we will be offering two new options for people having
difficulty affording their insulin:

 NNI $99.00 Cash Card Program for Analog Insulins: As part of this program,
people with diabetes can purchase any combination of Novo Nordisk analog insulins for
$99.00. This offer provides up to three vials or two packs of FlexPen ®/FlexTouch® pens
of any combination of Novo Nordisk analog insulins (3000 – 3600 Units total depending
on the brands) for a flat cost of $99.00.

• NNPI NovoLog® and NovoLog® Mix Follow-On Brands (also known as an

authorized generic): Follow-on brand versions of NovoLog® and NovoLog® Mix will be
available at a 50 percent discount compared to the current list price of the branded
versions. The follow-on brands will be made available from the newly established Novo
Nordisk US affiliate Novo Nordisk Pharma Inc. (NNPI) This company was established to
bring follow-on brands of Novo Nordisk branded analog insulin at a reduced list price for
people with diabetes who are facing affordability challenges. NovoLog® is Novo
Nordisk’s most widely prescribed insulin, used by approximately one million people with
diabetes in the US.

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