All three major PBM's may be changing the coverage of Lantus. Please check 2017 benefits as enrollment period is soon starting. while its not fully excluded, its better to get prepared to pay more in copay's and/or get the prior authorization for Lantus
In a bulletin seeking client feedback by Sept. 28, UnitedHealth said it is changing reimbursement terms for long-acting insulins and will no longer cover Lantus, the main insulin
drug sold by Sanofi (SASY.PA).
The insurer said Basaglar, a cheaper biosimilar insulin sold by Eli Lilly (LLY.N) would be covered as "Tier 1," meaning the lowest out-of-pocket costs for members. Levemir, produced by Novo Nordisk (NOVOb.CO), will move from Tier 1 to Tier 2.
CVS Health (CVS.N) made a similar move last month to drop Lantus in favor of Lilly's new biosimilar.