Why does insulin require a prescription in the US?


I was diagnosed in 2016 and have terrible neuropathy. Rapidly progressing neuropathy, started in my legs and is now in my hands (didn’t even know that was a thing until a month or two ago). Since my first post-diagnosis bloodwork, I’ve not had an A1c over 5.8%, and my average over the last two years is 4.9%.

So let me ask you…why would you assume the fact you’ve had no neuropathies was related to your ability to control your diabetes with NPH? And why would you think that just because you could do that, everyone else could or should be able to? The difference between NPH and analog insulin is much greater than “a convenience” for most diabetics I know, most who post here on this board, and certainly in my doctor’s opinion.


My guess is they made some insulin prescription only to protect the profits of the drug companies who fund their campaigns.

For one thing there are more regulations to stop people from buying prescription drugs abroad.

No doubt its all about money.


David I can only talk about my diabetes, and those have been my experiences. I am sincerely sorry that you can have such wonderful A1c’s and still have neuropathy in your hands and legs. That must be horribly frustrating.

In my experience NPH and Regular insulins worked fine as did beef and pork insulins. I know others who didn’t have major problems with these insulins.

I am happy that NPH and Regular insulins are still available. No, control may not be as good but at least it is insulin and it is cheap. It can save people from dying. People have died because they don’t realize that these insulins are available. I believe that all insulin should be very inexpensive, but it isn’t and these insulins can be life saving. I certainly don’t want people to be afraid of trying them.


This scares me and make me wonder if high sugar really is the mechanism of action.

I got to go I am not going down the rabbit hole of fear and worry right now, did that yesterday reading medical stuff.


David, I know that in my case, strict control saved me from retinopathy because my eyes cleared up when I brought my A1c way down. I know from what I have read, that good control saved Dr. Bernstein from many complications which got better the longer he kept strict control of his glucose levels. It sounds like very good control has not saved you from neuropathies and I don’t understand that, but diabetes is still a mysterious illness. The only time I get neuropathy in my feet is when I try to take a statin.

After 50 yrs with diabetes, I did end up with two heart stents, but the jury is still out as to the cause.


You and I are on the same page on this front! I just want to point out that while NPH and Regular can be life-saving, they are far more difficult to use successfully than analogs for most diabetics. And you’re absolutely right that all types of insulin should be affordable (heck, I say free).

And that was the point :slight_smile: I wasn’t trying to call you out or even disagree. It just sounded a bit like “NPH and Regular work great, look at me I never got complications!” We all know it’s a bit more complicated than that, and that having good control (I have very good control) is not always enough. Diabetes is complicated, and I strongly believe that financial status should not be a barrier to having the best tools available. For many of us, analogs are the best tools available (along with pumps and CGMs).


I solved the puzzle ! You need a prescription so they can criminalize people selling it for less then the big pharma-government collusion price on the free market.

They have no problem selling the more difficult to use and dangerous version of insulin over the counter cause there is little profit in that.

I did not read the whole thread, did anyone else solve the puzzle before me ??


You will love a CGM, just imagine being able to look all day for everything with rarely finger sticking. I just finger stick to make sure the meters close.


Marie, I still don’t know which one to choose. I was taken back by all the problems people are having. I don’t know if I want to deal with the frustration.


Its not the only factor. As Marilyn6 mentioned, genetics also plays a role. So does luck. But, A1c is one of the most influential variables.

No one here is perfect. Everybody is just doing the best they can. Thats all you can do.


The pharmacists are prevented from telling us that cheaper options exists. The Doctors dont tell us. Thats why people die when they cant afford $350 for insulin. If you are interested, the feds are holding a meeting on the topic this coming week. I’ll post it when I see it. Its scheduled for 2 days from today. They do discuss making insulin free and topics discssed here. https://www.finance.senate.gov/

@Marilyn6, new tech is always frustrating. It will make you mad, at first. But, not for long. You will learn SO MUCH about yourself and your illness. It really is priceless.


I just wish I didn’t have to “prove I still have T1” when health [plans, HCP’s, pharmacies have to be changed. Don’t they realiza that if I wasn’t T1 anymore I’d be dancing in the streets?


Insulin can’t be free, somebody pays for it.

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I have had diabetes for 19 years and have never used NPH or Regular. My first regimen was Lantus and Humalog. Today I’m just pumping Humalog.


If you have absolutely never used NPH or R, I would exercise real caution when trying it for the first time. Its different. I’m sure you could work through it with a Dex, though, in the short term.

@DonR, well, no, its not free. It costs several cents to manufacture. But, I do recall someone saying the word “free.” They were just throwing ideas around. None of the conversations sound really well thought out. You can listen to the hearing if you need more detail. I haven’t summarized it here - Its 3 hours long.

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I live in Texas and I get my insulin without a prescription. But I use the plain Jane variety… it’s probably because you use a pen.


In this case, “free” does not mean free of cost. In this context, it simply means no out-of-pocket cost for the user.

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I live in Indiana, thankfully close to the Michigan border. Up until 3 years ago, Indiana allowed the purchase of various forms of insulin without a prescription. Then, for some unknown insane reason, the state legislature decided to require prescriptions.

When I asked my state legislator about it, he said it was because insulin could be used as a weapon to kill people by causing them to go into hypoglycemic shock.

Now, I just go a couple of miles north to Michigan to buy insulin without a prescription.

Remember that health insurance companies always require a doctor’s prescription before they’ll pay for insulin…


Also remember folks… Walmart in the USA sells Humulin R and Humulin NPH (without a prescription except for Indiana) for $25.00 per vial. They also have a great blood testing meter (the ReliOn) for less than $10.00 and strips for about $25.00 per hundred.

If you can’t afford the expensive types (Humalog and Lantus), you can live a good, well balanced life as a diabetic by using NPH and R with frequent blood testing.

I don’t often praise Walmart, but they have saved a lot of lives by their inexpensive pricing for insulins and test strips…


You should talk to @IgotT1. He is having difficulty from Indiana. I’m gonna tag you both.