In a recent announcement on March 25, Eli Lilly, a prominent drug manufacturer, alerted the public about an impending shortage of 10mL vials of Humalog and insulin lispro injection, which are essential for many individuals with type 1 diabetes (T1D). The company attributes the shortage to a temporary pause in manufacturing and hopes to resolve the issue swiftly.
Updated: August 8, 2024. T1DStrong is committed to providing the latest updates on diabetes medication shortages throughout the year. Stay tuned for further information as we receive updates.
A study conducted by the Yale School of Medicine in April 2024 expressed concerns about the rising costs of new diabetes treatments offered by global insulin suppliers.
An unsettling consequence of prioritizing the production of more profitable GLP-1 receptor weight loss drugs over insulin products could aggravate the existing insulin shortage.
Following recent price regulation compliance earlier this year, major insulin manufacturers in the U.S., Denmark, and France significantly lowered their prices, benefitting patients.
Novo Nordisk’s decision to discontinue Levemir, a long-lasting insulin injection by the end of 2024, has resulted in disruptions within the supply chain. Shortages of Fiasp FlexTouch prefilled pens and vials are anticipated until January 2025 due to manufacturing delays.
In some regions, Novolin R Flexpens and Novolog 10 mL vials are on backorder without a clear restock date. Novo Nordisk also faces limited availability of Ozempic as they transition into 2024.
The scarcity of these vital medications poses a serious risk to patients.
At present, the supply of Eli Lilly’s Humalog and insulin lispro injection vials remains depleted, and Sanofi Aventis halted the production of its generic Lantus® (insulin glargine) in May 2024.
Continue reading to explore your options and learn how your advocacy can make a difference.
Current Situation of Diabetes
The Centers for Disease Control and Prevention (CDC) marked diabetes as an epidemic three decades ago. According to the American Diabetes Association (ADA), diabetes affects 11.6% of the population, making it a widespread national issue with over 1.2 million new cases annually. Additionally, an estimated 97.6 million Americans have prediabetes. While T1D affects only 1.45 million Americans, global projections suggest this number could double by 2040.
Given this context, the pressing question arises: how and why are insulin manufacturers facing shortages?
It is crucial for individuals with diabetes to monitor their blood sugar levels regularly and adhere to their treatment plan to prevent complications. Proper management of diabetes includes maintaining a healthy diet, engaging in regular physical activity, monitoring blood sugar levels, taking medications as prescribed, and attending regular medical check-ups.
Education about diabetes self-management is also essential to empower individuals to take control of their health. Support from healthcare providers, family, and diabetes educators can make a significant difference in managing the condition effectively.
Additionally, staying informed about new developments in diabetes treatment and technologies can help individuals make informed decisions about their care. Research shows that continuous glucose monitoring systems and insulin pumps can improve glucose control and quality of life for individuals with diabetes.
Overall, insulin plays a vital role in diabetes treatment, and ensuring access to this life-saving medication is critical for the health and well-being of individuals with diabetes.
Insulin shortages have also become a significant concern in recent years. Some patients have reported difficulties in accessing their prescribed insulin due to supply chain issues and manufacturing disruptions. The lack of availability of insulin can have serious consequences for individuals with diabetes, as it can lead to uncontrolled blood sugar levels and potentially life-threatening complications.
The combination of rising prices and shortages has put a strain on individuals who rely on insulin to manage their diabetes. Advocacy groups and healthcare providers are calling for action to address these challenges and ensure that insulin remains accessible and affordable for all who need it.
Regulatory Impact on Insulin Prices
In 2023, government regulations and patient advocates compelled manufacturers to reduce insulin prices, raising concerns about potential shortages. Starting from January 2024, the Inflation Reduction Act capped monthly insulin cost-sharing at $35. Major insulin manufacturers adjusted their co-pays to $35, slashing drug prices by 70%.
Tarsis Lopez, a spokesperson for Eli Lilly, stated to CNN, “The ebb and flow of insulin supply and demand, combined with a brief manufacturing hiatus, resulted in a temporary supply constraint.”
This development has left individuals with diabetes scrambling to secure insulin, with reports of patients searching multiple pharmacies for supplies, reminiscent of the panic-buying trends observed during the COVID-19 pandemic.
In addition to the dwindling supply of Humalog and insulin lispro injection by Eli Lilly, patients should be vigilant about possible shortages affecting the following:
- Novo Nordisk’s Novolin R Flexpens facing backorders, alongside the anticipated depletion of Fiasp FlexTouch 100 units/ml pre-filled pens from April 2024 to January 2025.
- Supply disruptions for GLP-1 RA medications (Ozempic, Trulicity, Victoza, Saxenda, Byetta, and Bydureon) could extend into 2025.
Checking for Manufacturer Assistance Programs
In situations where you may be facing financial difficulties in obtaining your diabetes supplies, it’s worth investigating manufacturer assistance programs. Many pharmaceutical companies offer patient assistance programs that can help individuals access their medications at a reduced cost or even for free. Check the websites of insulin manufacturers or contact them directly to inquire about available programs.
Creating a Diabetes Care Emergency Kit
It’s advisable to put together a diabetes care emergency kit that includes essential supplies such as insulin, syringes, test strips, glucose tablets, and a glucagon kit. Keep this kit easily accessible at home and consider carrying a compact version with you when traveling or in situations where access to your regular supplies may be restricted.
Utilizing Telehealth Services
Given the current circumstances surrounding the COVID-19 pandemic, telehealth services have become increasingly popular for remote healthcare consultations. Consider utilizing telehealth options to consult with your healthcare provider for routine check-ups, prescription refills, and guidance on managing your diabetes care effectively.
Staying Informed About Diabetes Care Updates
Stay updated on the latest developments in diabetes care by following reputable sources such as the American Diabetes Association, Centers for Disease Control and Prevention, and other healthcare organizations. Keeping informed about new treatment options, guidelines, and resources can help you proactively manage your diabetes and stay healthy.
Manufacturers’ Response and Call to Action
In a recent statement, Eli Lilly emphasized its acknowledgment of the critical need for insulin among its users, underscoring its commitment to supplying these essential medications. Lilly expressed, “Any disruption in the supply chain may affect individuals’ treatment routines, and we are acting swiftly to address it.”
Shifting between insulin brands or delivery methods poses challenges to the lives of many individuals with T1D, affecting households globally.
Reach out to elected officials and manufacturers, conveying that this issue surpasses minor inconveniences – people’s lives are on the line. You can contact legislators via email or phone. If unsure about your congressional district or identifying your representative, visit house.gov for assistance.
Let’s remain hopeful that this challenge will be promptly resolved as promised. In the meantime, stay informed, maintain your prescriptions, adhere to your insulin therapy regimen diligently, discuss alternative insulin options with your healthcare provider for emergencies, and make your voice heard.
Update on NovoRapid PumpCart Cartridges
The Department of Health and Social Care (DHSC) announced on June 4, 2025, that supplies of the NovoRapid PumpCart 1.6ml cartridges from Novo Nordisk will be limited throughout the year.
The NovoRapid (insulin aspart) PumpCart cartridges are utilized in the mylife YpsoPump insulin pump.
The scarcity may impact initiating new prescriptions for PumpCart cartridges. Diabetes care teams could review existing PumpCart users, with current users having the option to switch to insulin vials with disposable reservoirs. Alternative insulin products such as NovoRapid vials and mylife YpsoPump Reservoirs are recommended for those in need.
Patients transitioning to the mylife YpsoPump insulin pump filling system should ensure to access vials and reservoirs for seamless continuity of care.
Close monitoring of glucose levels is recommended after changing treatment methods, and it is advisable to consult the diabetes care team if necessary. Novo Nordisk will discontinue Levemir insulin by the end of 2026, so prescribing Levemir and switching patients to alternatives should be avoided until further guidance is provided. While NovoRapid FlexTouch pens have been discontinued, alternative options like NovoRapid FlexPen and Trurapi are still available. The discontinuation of Insulatard Penfill cartridges by mid-2025 will see Humulin I KwikPen as a replacement. Patients using discontinued pre-filled insulin devices like Insulatard Innolet can opt for alternatives such as Humulin I KwikPen. Although a shortage of Fiasp FlexTouch pens is expected until January 2026, Penfill cartridges will remain accessible. Tresiba FlexTouch pens are likely to be unavailable until January 2026; however, Penfill cartridges remain an option. It is essential to become familiar with new injection pens and monitor blood sugar levels closely when initiating a new insulin device. Stakeholders are urged to consider patient needs during insulin transitions and provide the necessary prescriptions. The introduction of insulin has transformed diabetes treatment, but affordability remains a significant barrier. Taking steps to address insulin affordability is crucial.
Innovation and progression in insulin therapy have made significant strides over the past century. The evolution from animal-derived to genetically engineered human insulin in the 1980s marked a pivotal moment in diabetes treatment. Subsequent decades ushered in new formulations like rapid-acting and long-acting insulin analogs, as well as innovative delivery methods such as insulin pens and pumps. Ongoing efforts aim to enhance insulin pharmacokinetics, simplify treatment, and reduce side effects through the development of novel insulin types. Technological advancements have also led to improved insulin delivery and monitoring with continuous glucose monitoring (CGM) systems and artificial pancreas systems. Despite these advancements, rising insulin prices pose challenges to accessibility and affordability, particularly in low- and middle-income countries. Enhancing the availability and affordability of insulin is essential for effective diabetes management.
Amidst the rising costs of insulin, especially due to expensive insulin analogs, affordability remains a significant concern for individuals. The escalating prices have led to challenges in adherence to treatment regimens, with many individuals skipping or rationing insulin doses to cope with the high costs. Policies affecting medication costs, such as cost-sharing features, can further impede medication use and adherence, particularly among low-income populations. Addressing cost-sharing barriers and promoting transparency in drug pricing are crucial steps towards making diabetes medications more affordable and accessible. Efforts to introduce generic drugs, shorten market exclusivity periods, and eliminate anticompetitive practices can help lower medication costs for individuals with diabetes. Enhancing transparency in drug pricing and empowering the federal government to negotiate drug prices are crucial strategies for improving medication affordability.
Generic drugs offer a lower-cost alternative to brand-name medications, contributing to significant cost savings in the healthcare system. The introduction of biosimilar insulins, although slow, provides a more affordable option for diabetes treatment. Strategies to enhance competition, timely availability of generics, and transparency in drug pricing negotiations are necessary to control prescription drug costs effectively. Legislative measures, such as those implemented in Medicare Part D, promote competition among private plans to lower drug prices. The role of pharmacy benefit managers in managing drug costs for Medicare Part D underscores the importance of increased transparency in rebates utilization. Medicare Part D beneficiaries face high insulin costs due to the absence of generic alternatives, necessitating the need for more affordable options and lower-cost insulin analogs.
Improving access to insulin involves controlling costs through the prescription of lower-cost options, the introduction of biosimilars, and increasing flexibility in price negotiations. Healthcare providers should weigh the costs of newer insulin analogs and consider recommending lower-cost alternatives like Human NPH and regular insulins available at discounted prices. Addressing weak competitive pressures and discouraging anticompetitive practices can help lower insulin prices and improve accessibility. Policies should aim to reduce market exclusivity for biological products and discourage multiple patents on a single drug to foster competition and improve access. Emphasizing transparency in drug pricing is crucial to eliminate distortions that impact patients negatively and ensure equitable access to essential medications like insulin.
SUMMARY
Improving access to medications and ensuring costs are aligned with benefits can be achieved through value-based pricing and insurance design. By simplifying pricing based on outcomes and clinical measures, patients can more easily obtain the medications they need.
Part D Senior Savings Model
Addressing regulatory barriers that limit value-based pricing is crucial. Innovative models such as the Part D Senior Savings Model, which reduces out-of-pocket costs for insulin, can greatly benefit Medicare beneficiaries with diabetes.
Insulin, a key treatment for diabetes, has had a significant impact on the lives of those with the condition. Despite its importance, nearly half of the global diabetic population requiring insulin cannot access or afford it, with a significant portion in the United States facing financial challenges that lead to rationing or skipping doses.
To address these disparities and ensure access to insulin, collaboration among various stakeholders is essential. Government agencies, professional organizations, pharmacy benefit managers, and insulin manufacturers must work together to improve availability and affordability. Strategies such as adopting lower-cost options, facilitating biosimilar insulins, and promoting transparency in drug pricing can all contribute to making insulin more accessible to those in need.
It is important for both healthcare providers and patients to consider the costs and benefits of insulin therapy. Collaboration and implementing value-based pricing can help ensure that all individuals with diabetes have access to this essential medication, reducing the risks of complications and premature death associated with underuse due to financial constraints.
DISCLOSURE: Neither W. H. Herman nor S. Kuo have any relevant financial disclosures.
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