Cost Is the Biggest Barrier to Insulin Adherence — Here's How to Help

You know the clinical profile. Toujeo (Insulin Glargine U-300) delivers a flat, extended basal insulin curve with potentially fewer hypoglycemic events than U-100 glargine. Your patient needs it. But when they get to the pharmacy and see a price tag of $350 to $550 per month, many walk away without filling the prescription.

Insulin non-adherence due to cost isn't a hypothetical — it's a daily reality. Studies consistently show that 1 in 4 insulin-dependent patients have rationed or skipped doses due to cost. The downstream consequences — hospitalizations for DKA, accelerated complications, avoidable ER visits — cost the healthcare system far more than the insulin itself.

This guide gives you a practical framework for connecting your patients with Toujeo savings programs, identifying lower-cost alternatives when appropriate, and building cost conversations into your clinical workflow.

What Your Patients Are Paying for Toujeo

Understanding the pricing landscape helps you anticipate barriers:

• Cash price (uninsured): $175–$200 per Toujeo SoloStar pen (1.5 mL, 450 units); $450–$550 for Toujeo Max SoloStar (2 pens, 3 mL each). Monthly cost typically $350–$550+ depending on dose.
• Commercially insured: Varies widely. Toujeo typically sits on Tier 3 (preferred brand) or Tier 4 (non-preferred brand). Copays range from $30 to $150+/month. Some plans require prior authorization or step therapy through U-100 glargine first.
• Medicare Part D: Covered on most formularies. Patients benefit from the $2,000 annual out-of-pocket cap (effective 2025). However, monthly costs before reaching the cap can still be significant.
• Uninsured: Without assistance programs, the full retail price applies. This is where manufacturer programs are critical.

Manufacturer Savings Programs

Sanofi offers two primary programs that can dramatically reduce patient costs. Familiarity with these is essential for any prescriber managing insulin-dependent patients.

Sanofi Insulins Valyou Savings Program

• Eligibility: Uninsured patients or insured patients choosing to pay cash (not using insurance).
• Cost: $35 per 30-day supply of Toujeo or unbranded Insulin Glargine U-300.
• How it works: Patient presents a Valyou Savings card at the pharmacy. No income verification required.
• Enrollment: Online at toujeo.com/coverage-and-savings or by calling 855-706-4473.
• Clinical note: This program also covers the authorized generic (unbranded Insulin Glargine U-300), which is pharmaceutically identical to Toujeo.

Sanofi Insulins Copay Savings Card

• Eligibility: Commercially insured patients (not eligible for government-funded insurance like Medicare, Medicaid, or Tricare).
• Cost: Patients may pay as little as $0 copay per 30-day supply.
• How it works: Applied at the pharmacy like a secondary insurance card.
• Enrollment: Same website as above or via the Sanofi Insulins savings app.
• Limitations: Terms, conditions, and maximum savings per year apply. Not valid for government-insured patients.

Sanofi Patient Connection Program

• Eligibility: Patients who are uninsured or underinsured and meet income criteria.
• Cost: Free Toujeo for qualifying patients.
• Enrollment: Apply at sanofipatientconnection.com or call 888-847-4877.
• Clinical note: This is a patient assistance program (PAP) — the application requires prescriber involvement (prescription and sometimes a brief form). Consider having your staff incorporate PAP enrollment into the workflow for patients who express cost concerns.

Coupon and Discount Cards

For patients who don't qualify for manufacturer programs — or who prefer to compare options — third-party coupon platforms can provide meaningful savings:

• GoodRx: Aggregates pharmacy prices and provides coupons that can reduce cash price significantly. Patients can compare prices at nearby pharmacies at goodrx.com/toujeo.
• SingleCare: Similar discount card model with pricing at major chains.
• RxSaver, Optum Perks, BuzzRx: Additional coupon card platforms that may offer competitive pricing depending on location.
• Inside Rx: Backed by Express Scripts, sometimes offers particularly good pricing on brand insulins.

A practical tip: encourage patients to check 2-3 of these platforms before filling, as pricing varies by pharmacy and platform. Medfinder for Providers can also help your practice identify pharmacy availability.

Generic Alternatives and Therapeutic Substitution

When cost is prohibitive despite savings programs, therapeutic alternatives may be appropriate:

Authorized Generic: Unbranded Insulin Glargine U-300

Sanofi offers an authorized generic of Toujeo — unbranded Insulin Glargine U-300 in both SoloStar and Max SoloStar presentations. It is the same product (same formulation, same device, same manufacturer) without the Toujeo brand name. It's eligible for the $35/month Valyou program. For uninsured patients, this is functionally identical to branded Toujeo at a fraction of the cost.

U-100 Insulin Glargine (Lantus and Biosimilars)

If a patient's insurance covers U-100 glargine preferentially:

• Lantus (Insulin Glargine U-100) — The original brand.
• Basaglar (Eli Lilly) — Biosimilar, often preferred on commercial formularies.
• Rezvoglar (Eli Lilly) — Interchangeable biosimilar.
• Semglee — Note: Semglee was discontinued in early 2025. Patients previously on Semglee need an active alternative.

Clinical consideration: Switching from Toujeo U-300 to a U-100 glargine product is not a simple 1:1 conversion. Toujeo's pharmacokinetic profile differs — patients switching to U-100 may need a dose reduction of approximately 20% and closer monitoring to avoid hypoglycemia. See the alternatives to Toujeo guide for more detail.

Other Basal Insulin Options

• Tresiba (Insulin Degludec) — Ultra-long-acting with up to 42-hour duration. Similar flat profile to Toujeo. May be preferred on some formularies.
• Levemir (Insulin Detemir) — Long-acting, often requires twice-daily dosing. May be more affordable on certain plans.

Walmart ReliOn Insulin

For patients in severe financial distress, Walmart's ReliOn brand offers NPH and Regular insulin over the counter for approximately $25 per vial. This is not a therapeutic equivalent to Toujeo — it's an older insulin with a very different profile and requires careful patient education on timing, dosing, and hypoglycemia management. It should only be considered as a bridge in emergency situations, not as standard substitution.

Building Cost Conversations Into Your Workflow

Cost discussions shouldn't be an afterthought. Here are practical strategies for integrating them into your prescribing workflow:

1. Ask About Cost at Every Insulin Visit

A simple question — "Are you having any trouble affording your insulin?" — can open the door. Many patients won't bring up cost unprompted, either out of embarrassment or because they don't know alternatives exist.

2. Check Formulary Before Prescribing

Use your EHR's formulary lookup or tools like CoverMyMeds to check whether Toujeo is covered on your patient's plan before sending the prescription. If it requires prior authorization, initiate it during the visit rather than leaving the patient to deal with a rejected claim at the pharmacy.

3. Equip Your Staff with Resources

Create a one-page handout or a digital resource with:

• The Valyou Savings Program number: 855-706-4473
• The Patient Connection Program number: 888-847-4877
• Links to GoodRx, SingleCare, and Medfinder for Providers
• Step-by-step instructions for applying to Sanofi's PAP

Train medical assistants and front-desk staff to hand this to any patient receiving an insulin prescription.

4. Document Cost Barriers in the Chart

Note cost-related non-adherence in the patient's medical record. This supports prior authorization requests ("patient unable to afford alternative") and ensures continuity if the patient sees another provider.

5. Follow Up on Fills

Consider implementing a workflow check 7-10 days after prescribing to confirm the patient filled their prescription. A quick phone call or patient portal message can catch problems early — before the patient runs out of insulin or starts rationing.

6. Leverage Social Work and Care Coordination

If your practice has a social worker or care coordinator, loop them in for patients with complex financial situations. They can navigate PAP applications, insurance appeals, and community resources more efficiently than clinical staff.

Final Thoughts

The best insulin in the world doesn't work if your patient can't afford to fill it. Toujeo offers meaningful clinical advantages for many patients — but only if they can access it consistently.

The good news is that the savings landscape for Toujeo is more robust than many providers realize. Between the $35/month Valyou program, $0 copay cards for commercially insured patients, and free insulin through the Patient Connection Program, most patients have a viable path to affordable Toujeo.

Your role as a prescriber is to know these options exist, proactively raise the cost conversation, and build systems in your practice that connect patients to the right program. It takes a few extra minutes per encounter — but it can make the difference between a patient who controls their diabetes and one who ends up in the ER.

For more tools to support your practice, visit Medfinder for Providers. For patient-facing resources on availability, costs, and alternatives, explore our patient savings guide and pharmacy finder guide.