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Gabe Graham
Gabe Graham

Can You Buy Insulin Without A Prescription

There are two types of human insulin available over the counter: one made by Eli Lilly and the other by Novo Nordisk. These versions of the medicine are older, and take longer to metabolize than some of the newer, prescription versions; they were created in the early 1980s, and the prices range from more than $200 a vial to as little as $25, depending on where you buy them.

can you buy insulin without a prescription

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Still, some people with diabetes, as well as some doctors, doubt that the benefits of that greater availability outweigh the risks, especially for patients who switch from one type of insulin to another without telling their doctor.

Dr. Todd Hobbs is chief medical officer of Novo Nordisk in North America, which makes Novolin, one of the two versions of insulin sold over the counter. His company partners with Wal-Mart to sell its version under the brand name ReliOn. (Wal-Mart declined to be interviewed for this story.)

Carmen Smith now gets the insulin she needs via her doctor's prescription. When she lacked health insurance, buying a version of the medicine over the counter was cheaper, she says. But it was hard to get the dose right. Lynn Ischay for NPR hide caption

As anyone with diabetes can tell you, managing the disease with insulin usually means regular checkups at the doctor's office to fine-tune the dosage, monitor blood-sugar levels and check for complications.

"It's not like we go in our trench coat and a top hat, saying, 'Uh I need the insulin,' " says Smith, who lives in Cleveland. "The clerks usually don't know it's a big secret. They'll just go, 'Do we sell over-the-counter insulin?' "

Smith keeps the tools for controlling her diabetes in this kit, which contains metformin, syringes, fast-acting insulin for daytime use and slow-release for overnight. Lynn Ischay for NPR hide caption

Smith didn't learn from a doctor that she could buy insulin that way. In fact, many doctors don't know it's possible. When she no longer had insurance to help pay for doctors' appointments or medicine, Smith happened to ask at Wal-Mart if she could get vials of the medicine without a prescription. To figure out the dose, she just used the same amount a doctor had given her years before.

The availability of insulin over the counter presents a real conundrum. As Smith's experience shows, without training or guidance from a health care provider, it can be dangerous for a patient to guess at the best dosage and timing from version to version of insulin. On the other hand, being able to afford and easily buy some when she needed it may have saved her life.

There are two types of human insulin available over the counter; one made by Eli Lilly and the other by Novo Nordisk. These versions of the medicine are older, and take longer to metabolize than some of the newer, prescription versions; they were created in the early 1980s, and the prices range from more than $200 a vial to as little as $25, depending on where you buy them.

The U.S. Food and Drug Administration declined multiple requests by NPR for an interview on this topic. But, in an email, an FDA representative said that the versions of insulin now available over the counter were approved for sale that way because they are based on a less concentrated, older formulation, "that did not require a licensed medical practitioner's supervision for safe use."

"This is not something that should be done without the help of a professional," says David Kliff, who has Type 1 diabetes and writes the Diabetic Investors blog. Kliff has followed and written about the expanding business of diabetes for years.

"They look at insulin as a drug," he says, "and say, 'There's this enormous body of evidence that shows that the drug is safe.' But, you know, there's a little asterisk at the end there. What the little asterisk basically says is: 'You know, that's assuming that the patient is trained on it.' "

"I didn't realize that insulin was over the counter in Indiana until two of my patients, who were in good control, suddenly had increased glucoses," Burke says. He asked them if they had changed their diet, lost weight, altered their workout routines. They had not.

Burke says he took his concerns to the American Medical Association. But the national doctor's association told him there are no data showing that the drug's over-the counter availability is a public health hazard. In fact, the AMA's board noted, getting insulin without a doctor's prescription may be an important way for some insulin-dependent patients to get access to the medicine they need.

"We clearly think the newer versions are more close to what the body would do on its own," he says. The prescription versions are better and safer, he agrees, because they make it easier for patients to avoid wild fluctuations in blood sugar.

Patients who switch to these insulins without guidance from a healthcare professional may be unaware that these insulins do not work in the body like the newer insulin they were likely taking before. This can lead to severe blood sugar fluctuations and be potentially fatal.

There is erroneous information in this article about human synthetic insulin. The description of its action peaking at 4 hours and lasting for 12 is for the NPH version,. Regular synthetic insulin has a peak at about 2 hours.

Thank you for a very well written reply. the old insulins are as good as the new ones and much less expensive, and in my experience, the analog insulins require higher doses than the old preparations, The pharmaceutical companies have been doing a massive training program aimed mostly at diabetologists to convince them to recommend the more expensive drugs.

I started getting Relion Novolog from Walmart, after my Prescription for Lantus was economically unavailable to me do to a Stop Gap or Donut Hole with my insurance. I started on July 1st 202, with my first 44 unit injection, i developed a bump under my skin at the injection sight. I called Walgreen, the pharmacist told me to massage the bump ( i did). Nothing,,,, i called my Doctor, she didnt seem too concern. I continued the injections, went to see my Doctor, she asked do i want to get back on Lantus, how? I am a senior, living on a low income fixed budget. Lantus would cost me $277.00 for 10 pens. I cant afford that. So now i have 20 plus bumps going around my navel. I kept every Relion pen i have used. It was always cloudy, the pharmacist said to shake the pen. Im just putting this on record. I will send pictures and i left insulin in the used pens, in case something serious happens. It never brought my Blood sugar levels down, only 25-40 points. I stop even using them on September 30. I know you wont publish my comment.

The N insulin should be cloudy. It always appears cloudy in the bottle and the syringe. The cloudiness has nothing to do with refrigeration or being defective. The R insulin should be clear. Expensive or cheap, N is always cloudy.

Over-the-counter (OTC) insulin is sold more often at Walmart than at other pharmacy chains, most likely because of its lower cost and patients' inability to afford co-pays for prescription insulin, new research suggests.

The results showed that OTC insulin is sold more commonly at Walmart than at other pharmacy chains and that inability to afford co-pays for prescription insulin was noted as a common reason for purchase, particularly at Walmart pharmacies.

In the United States, human insulins such as NPH and Regular insulin (and 70/30 mixtures) are available OTC in every state except Indiana. Walmart's own ReliOn brand of insulin (manufactured by Novo Nordisk) is considerably less expensive than the branded human insulins sold at other pharmacy chains, at approximately $25 vs $152-$163 for 10-mL vials of Novolin (Novo Nordisk) or Humulin (Eli Lilly). In contrast, insulin analogs such as lispro (Humalog, Eli Lilly), aspart (Novolog, Novo Nordisk), and glargine (Lantus, Sanofi) require prescriptions.

In an interview, Goldstein told Medscape Medical News, "Prescription [analog] insulins are considered by many to be easier to use and more predictable than the human insulins available over-the-counter. However, insulin prices have skyrocketed over the past decade and many patients with diabetes have had to ration their prescription insulin because of cost."

She cautioned that although human synthetic OTC insulins "may be an important treatment option for patients with diabetes who are uninsured or underinsured...use of such insulins without medical supervision is never recommended and could be very dangerous."

In 2018, Goldstein and colleagues conducted telephone surveys of employees of six Walmart pharmacies in each of the 49 states that allow OTC insulin and of other pharmacy chains (CVS, Walgreen's, or Rite Aid) geographically closest to each Walmart. 041b061a72


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