Why do we need prescriptions?

Taking off on the post from Bobby (where he can’t get a refill of pump supplies), has brought up an old conundrum for me.

  • T1 diabetes - there is no current cure
  • Pumps & pump supplies are essentially just pieces of "hardware" (not a "drug")
  • Insulin, while a drug that can have powerful effects, is the only effective treatment to manage diabetes and is largely self-administered by T1s
So, once you have been diagnosed, and begin pump therapy, why do you need a prescription to continue receiving these supplies? Especially when NOT receiving them can be life-threatening.

I can almost see it for insulin, because in theory your doctor is tracking your management of the disease and your insulin requirements may change over time, but it doesn't go away and you still need a delivery mechanism.

Fair Winds,

Insulin is available OTC without a prescription in most of the US. But only the good old fashioned ones like R and N, not the trendy new fast-acting fancy-pants insulins like Humalog and Novolog.

You’re right, it is ironic, that insulin is OTC, but pump supplies seem to require prescriptions, and even in some localities/states syringes require prescriptions.

It is all about the insurance companies. They want control over what we use, how we use it and when we use it. I have purchased OTC syringes and insulin.

I totally agree, my dear friend:) I suspect control of the patient is high on the list…especially since meds and durables are so expensive. I remember arguing w/ my insurer when I left for Africa for the summer and needed more than 1 month of supplies to take with me. If I did not need a prescription, I could request what I needed and insurance would have to pay. With the extra step, they can place restrictions and keep you tied to your MD for approval. I have also had more than 1 situation where I lost or broke my vial of insulin when I could not get to a pharmacy or I required approval for an additional vial. I look forward to the day when we make treatment and supplies more accessible…it would result in healthier patients, I think:)


It may depend on where you live. I am pretty certain that I need a prescription for a glucagon kit. Which will add $9 to $15 dollars to the overall cost. Just to be sure that my insurer will reimburse the expense.

We live in Canada and I can walk into any pharmacy and ask for a vial of novorapid, syringes, test strips and lancets without prescription and I do. I never order under prescription for these items to avoid the $9 to $15, added, prescription fee, and the pharmacy is required to provide me with a receipt that I am able to forward on to my insurer. As for pump supplies, I order directly from the manufacturer as a three month standing supply so that I get a 15% discount for the standing order and I have never provided a prescription for it yet.

My understanding is that in an emergency, my son can walk in to any pharmacy in Ontario, where we live, tell them that he is a diabetic and in need of a syringe with so many units of insulin and be given it, without cost, by providing ID and his Ontario health card.


The problem is in the US if one runs into the same situation… You could end up paying for a costly ER visit just for a scrip for insulin and (in some states/cities) the syringe to inject it with… Though a lot of states are having a “compromise” where you can get a pack of syringes (as in thr 10 count sealed pack in a case)… if you know what size and gauge you want without a prescription. No more… The day i can walk into a pharmacy and just grab and go a bottle of humalog or novalog and syringes… Sigh… that would make life so much easier

We wont even discuss if you run out of sets because your insurer is very tight on the refill gap… Fortunately my DME supplier has been rather generous about it… iv already had two panic episodes on getting infusion sets because of the tightness on refill vs quantity on hand… I heard that the Orbit 90 was trying to become avalible in major pharmacies in the us as a prescription item. at least youd be able to get a set or a few in a pinch…

Hi, I live in Canada too and was recently on vacation and forgot my 6-year old son’s glucagon kit at my parents’ house, so I went to the pharmacy closest to the airport and told them I needed a glucagon kit for my son, they wrote out a receipt so I could claim it later, no problems, no questions…it was Shopper’s Drug Mart.

This topic has always been on my mind since dx. Because of my T1, I basically have to see a doc at least once a year for the rest of my life, otherwise my scrips expire, and along with that, my doc will nag me to see the eye doc, take statins, and get labs. All sensible but I don’t like it and neither does my wallet.

I don’t have a problem with the doctor visits because you SHOULD be getting the labs, eye exams, etc. If your doctor needs to nag you, well that’s another discussion.

I’m really on about is the call to the pharmacy/pump supply folks and being told, “We will require a new prescription before we can fill this”, and there is no understanding on their part (or desire to understand). I once requested talking with a “supervisor” who carried the title “Senior Customer Resolution Specialist” who fed me the exact line the first person gave (aka, “no and hell no!”). Then I was transferred to the “Senior Pharmacist” who said, “We need to hear from your doctor because your need for this medicine may have changed.” HA!

On reflection I realized that what they were hoping for was that my prescription would be for less since that saves them money, or perhaps that my T1 was cured!

Sorry for the rant!

Fair Winds,

I just don’t understand why people have this confusing view of prescriptions and their role in the medical system. The reason you need a prescription is because your doctor needs your money. If did not need a prescription, then you would not have to see the doctor, and he would not get your money. I hope I was clear about that.

cause athletes can use it as a performance enhancing drug:
For baseball players, especially pitchers, it is insulin’s effect on muscle breakdown that offers the most positives. HGH was thought to help speed recovery, a must for a player returning from injury or just recovering from a back-to-back usage out of the bullpen. Players are often seen losing not only weight but muscle mass over the course of a season due to high temperatures and an inability to keep up a normal workout schedule. While the explosive anabolic gains that many expect to see from a potent substance like insulin aren’t going to be visible, the reduction of losses is just as important to many players.

The problem is that scripts are oftentimes overused as a cash cow for the physicians office… Theres a few places in boston who practically hold you at ransom, to make that copay or worse cash for that office visit just for a refill even if you go there a few times a year already.

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You state “there is no understanding on their part”

What exactly, are they supposed to understand? The FDA and US law dictates that those items may only be dispensed with a proper prescription. No amount of “understanding” can really allow a company to break that law at a customer’s request - think of how much trouble that would get them into.

If you want to change things, start with the legislation that makes the rules these companies must follow. Don’t blame the companies for doing the right thing.

You are absolutely correct. Thanks.

Fair Winds,

I can see why you would need a prescription to start because you wouldn’t want people who don’t need these medications/supplies and creating a supply and demand problem. I don’t want people just going to the pharmacy and buying dozens of bottles and then selling it and not knowing if the insulin has been kept cold, isn’t expired, etc. It could be really dangerous for people.

However, it really irritates me that my prescription for insulin (once I have it) expires. As you said, diabetes doesn’t have a cure. My need for insulin doesn’t stop after 6 months! Ugh. Same with test strips. Once you have a prescription, I think it should always be valid if the doctor says “Yes, this patient will always need this drug.” Sigh.

Type 1, 17+ years here. I understand that there are laws, and that doctors and pharmacies, etc. need to abide by the laws. But, like someone said earlier, I really hate it when doctors use my need for a prescription as a “cash cow”. (Warning, rant ahead:) I had a doctor give me an ultimatum one time because he didn’t think I was coming in to see him enough, so he refused to write me a prescription for more than one month unless I came in for another, definitely unnecessary, visit. He literally had his nurse tell me “We’ll write you a prescription for a month’s worth, but we won’t renew it or write you another one unless you come in again.” They made me feel like I was some sort of junky. Like my need for insulin was just going to stop? You better believe I left that doctor’s practice and found another doctor who’d write me a prescription that was good for a year, not just good for a few months. I really feel that dealing with bureaucracy is the absolute worst part about being diabetic. It wouldn’t be so bad if I didn’t feel like I was constantly having to fight to get the care I needed.

Bureaucracy is definitely one of worst parts of being diabetic. Most people and medical care-givers are not dealing with chronic conditions therefore their whole mind-set about getting a scrip and the occasional trip to the pharmacy is casual. And T1 adds a whole another layer of ignorance to the deal. I just loved this time when someone (not my doc) in the office adjusted my bg strip scrip down to 2x a day because of their ignorance regarding T2 vs T1. Another time I paid an extra copay to receive lancets that I did not request.

i’m not too sure about that - AFAIK, drugs are controlled at the federal, not state, level.

And the reason you need a prescription to receive insulin is simple - to make sure you are under the continuous care of a licensed physician.

I use Minimed as my DME supplier, and they will contact my endo for a new script when it runs out

it’s also to prevent misuse/abuse -

if i throw out my back, i need to go to the doctor to be examined before i can pick up vicodin for the pain. (high likelihood of abuse with narcotic painkillers.)

insulin can easily be misused - most people on TuDiabetes seem to have a pretty firm grasp on how to dose insulin and adjust their dosage rates, but many people don’t understand that. It’s far more dangerous to give anyone a vial of insulin that asks for it than it is to require a prescription - think about it as a permission slip that says “i need insulin, and i’ve been trained on how to use it”