Medicare Part D spending · FDA facts · help paying
Humalog (insulin lispro): what Medicare Part D spends and the dated federal facts we hold
CMS's Medicare Part D spending dataset lists Humalog under 3 names; the sum of their gross spending is $660.78 million in 2024, across 2,063,051 claims. 2 assistance programs list insulin lispro, each with its income ceiling and when we read it. The FDA's enforcement reports name this drug's packages in 2 recall entries.
Medicare Part D spending
CMS's Medicare Part D spending dataset lists Humalog under 3 names; the sum of their gross spending is $660.78 million in 2024, across 2,063,051 claims. CMS's dataset states spending is gross drug cost and does not reflect manufacturers' rebates or other price concessions. Spending is the total paid by Medicare, plans and beneficiaries for the drug's claims, not what a patient pays.
| Year | Gross spending | Claims |
|---|---|---|
| 2024 | $660.78 million | 2,063,051 |
| 2023 | $1.89 billion | 2,080,012 |
| 2022 | $1.74 billion | 1,956,279 |
| 2021 | $1.69 billion | 1,980,307 |
| 2020 | $1.66 billion | 2,152,832 |
Names CMS reports it under
| Name in the CMS file | Year | Gross spending | Claims |
|---|---|---|---|
| Humalog Kwikpen U-100 | 2024 | $334.33 million | 1,392,033 |
| Humalog Kwikpen U-200 | 2024 | $228.03 million | 159,898 |
| Humalog | 2024 | $98.42 million | 511,120 |
Source: CMS Medicare Part D spending by drug (data-year-2024, modified 2026-06-25), read November 7, 2026. CMS dataset page. All manufacturers combined; the figures are a drug-level aggregate of claims and say nothing about a formulary or coverage.
Medicare Part B payment limit
CMS publishes a quarterly payment limit for the HCPCS code that its NDC crosswalk links to Humalog. It is a ceiling for providers who bill Medicare Part B, not a price a patient pays, and a code's presence says nothing about whether Medicare covers a product.
| HCPCS code | Quarter | Payment limit | Per dosage descriptor | Effective | Read |
|---|---|---|---|---|---|
| J1817 | 2026 Q4 | $3.12 | 50 UNITS | October 1, 2026 through December 31, 2026 | November 7, 2026 |
Source: CMS ASP pricing files (october-2026-medicare-part-b-payment-limit-files-final.zip and the matching NDC-HCPCS crosswalk). CMS ASP pricing files page.
Biosimilar status
- Humalog (insulin lispro) is a reference product in the FDA Purple Book (BLA 020563, approved June 14, 1996). The Purple Book lists 0 biosimilars and 0 interchangeable products that name it as their reference product.
- Humalog (insulin lispro) is a reference product in the FDA Purple Book (BLA 205747, approved May 26, 2015). The Purple Book lists 0 biosimilars and 0 interchangeable products that name it as their reference product.
This is what the FDA Purple Book lists on the read date. It is a record, not a forecast of when any product will launch or be substituted.
Source: FDA Purple Book (purplebook-2026-10), read November 7, 2026. Purple Book data file.
Medicaid use by state
CMS's State Drug Utilization Data records, for 2025, how many prescriptions each state's Medicaid program paid for under this drug's packages and what it reimbursed. The 9 states with the largest reimbursement are shown. Reimbursement is before the rebates manufacturers pay states, so it is not a net cost and not a price a patient pays.
| State | Medicaid-paid prescriptions | Medicaid reimbursed | Covers |
|---|---|---|---|
| OK | 1,589 | $283,938 | Fee-for-service only |
| CO | 2,013 | $281,560 | All record types |
| RI | 100 | $139,084 | Fee-for-service only |
| PR | 155 | $111,038 | All record types |
| AL | 241 | $35,693 | All record types |
| SD | 63 | $22,491 | All record types |
| UT | 79 | $16,374 | Fee-for-service only |
| DC | 76 | $8,377 | Fee-for-service only |
| ND | 51 | $8,027 | All record types |
Where the publisher suppresses small managed-care cells, a state's figure covers fee-for-service claims only and understates use (5 state and package figures are marked that way here). A state missing from the table means its figures were suppressed or not reported, not zero use. 375 older-year figures are held and left out of the table.
Source: CMS State Drug Utilization Data (State Drug Utilization Data 2025, modified 2026-07-13T15:28:32Z), read November 7, 2026. CMS dataset page. State-reported data compiled by CMS; aggregate by state and package, no provider or patient data.
Medicaid spending
CMS's Medicaid spending dataset reports $216.37 million for Humalog in 2024. CMS's dataset states spending includes Federal and State reimbursement and dispensing fees and is not reduced by Medicaid rebates paid to the states. Spending is what Medicaid paid, not what a patient pays.
| Year | Spending | Claims |
|---|---|---|
| 2024 | $216.37 million | 820,262 |
| 2023 | $604.67 million | 925,184 |
| 2022 | $538.20 million | 828,811 |
| 2021 | $573.47 million | 953,936 |
| 2020 | $503.54 million | 914,246 |
Source: CMS Medicaid spending by drug (data-year-2024, modified 2026-06-25), read November 7, 2026. CMS dataset page. A national drug-level aggregate; it says nothing about any state's coverage rules.
Where help paying exists
Programs in our finder that list insulin lispro. Each shows its income ceiling, when we read it and whether we checked it against the program's own document. Eligibility is decided by the program, not by us.
- Lilly Cares Foundation manufacturer
Income at or below 300%, 400% or 500% FPL depending on the Lilly Cares group of your medicine ($47,880, $63,840 or $79,800 for one person)
Ceiling read on the program's own document, November 6, 2026. - Lilly Insulin Value Program manufacturer
No income limit in our data
Figure not yet re-read on the program's own page.
Check where your income sits against each ceiling: open the assistance finder. See what has changed and when we last verified each program on the program status board.
Label changes
The FDA file lists no non-manufacturing label change for these applications since November 11, 2025. The most recent one it lists is dated May 7, 2025 (Labeling).
Source: FDA Drugs@FDA data file, read November 7, 2026. Dates are the FDA action dates; the documents are on FDA's own site. FDA data file. All recent changes across these drugs: label changes feed.
Safety notices
FDA enforcement report entries that name a package of Humalog by its NDC: 2 entries, newest first. FDA assigns each a class by health risk: Class I is the most serious and Class III the least. An entry records what the recalling firm reported and FDA classified; it is not advice about any package you hold.
| Reported | Class | Status | Recalling firm | Reason (shortened) | Packages named |
|---|---|---|---|---|---|
| April 24, 2024D-0445-2024 | Class II | Completed | Eli Lilly & Company | CGMP Deviations | 7 |
| May 25, 2022D-0882-2022 | Class I | Completed | Cardinal Health Inc. | TEMPERATURE ABUSE: Products were exposed to temperatures outside of the products labeled storage conditions due to inclement weather. | 7 |
Source: openFDA drug enforcement reports, file read November 7, 2026. openFDA data file. All recent recalls across these drugs: drug recalls feed.
Questions
Does Medicare have a negotiated price for Humalog?
The CMS negotiated-price file we read does not list Humalog, so this page shows no negotiated price. A drug appears in that file only when CMS selects it for negotiation, and not being listed says nothing about what it costs a patient.
Is there help paying for Humalog?
2 assistance programs list it in our finder. Eligibility depends on income, coverage and the program's current rules; each program's own page decides.
How much does Medicare Part D spend on Humalog?
CMS's Medicare Part D spending dataset lists Humalog under 3 names; the sum of their gross spending is $660.78 million in 2024, across 2,063,051 claims. CMS's dataset states spending is gross drug cost and does not reflect manufacturers' rebates or other price concessions. Spending is the total paid by Medicare, plans and beneficiaries for the drug's claims, not what a patient pays.
For developers: this drug as data
One call returns the generic-entry upper bound, label history, recalls, trials, assistance and Part D spending, and where facts exist the FDA safety program (REMS), DEA schedule, orphan designations, safety notices and Medicaid use by state, each with receipts.
Example file: https://omnirx.org/api/v1/dossier/humalog.json
The licence page sets out what a data licence covers, and the API page documents these files.
Evaluation files with receipts; contract may change; not clinical advice.
Sources and terms. This drug is not in the CMS negotiated-price file, so no price source is used. Program details read from each program's own pages; CMS Medicare Part D spending by drug; CMS Medicaid spending by drug; CMS ASP pricing files; FDA Purple Book; FDA Drugs@FDA and Orange Book data files; openFDA drug enforcement reports. Figures are stored with their sources in the OmniRx library (edition 2026-11). Free to cite with attribution. Not medical, legal or financial advice. Report an error through the contact page. Licence the data.