A year ago, Eli Lilly, which makes several types of insulin, capped out-of-pocket costs for the drug at $35 monthly at participating retail pharmacies for people with commercial insurance using Lilly insulin. Sanofi has said that most of those who use its insulin products pay about $15 out of pocket per month, or $180 per year, because of a copay assistance program. Novo, which had reduced the price of one popular form of insulin called Levemir, then announced it would discontinue the product in the United States.