Insulin can be expensive and unaffordable even for those with insurance. Newer insulins and programs may help ease the financial burden, to help people avoid rationing or skipping doses.
Insulin is expensive in the United States for many people with diabetes.
The Insulin Affordability Crisis in America has forced many people with diabetes to ration their insulin, and some have even died as a result.
While insulin costs have started easing for some people in recent years, this hormone remains unaffordable and inaccessible to many people, and that can lead to less-managed diabetes and possibly dangerous medical emergencies if they can’t get the insulin they need.
There is help for those who can’t afford or access their needed insulin, including discussing options with your healthcare team on affordability or different options that might work for you.
The answer to that question isn’t simple.
List prices of insulin are what you’d pay without any insurance or discounts. This is what can be hundreds of dollars for a single insulin vial or prefilled pen.
Insulin pricing at a glancePeople with diabetes may take more than one type of insulin, at different times of the day or night. Fast-acting insulins are what’s used in an insulin pump for a continuous rate throughout the day, taken at meal-times or to correct high blood sugars, while long-acting insulin may be taken once or twice a day to maintain a constant insulin level in the body.
The list price for namebrand insulins like Humalog can be $300 or higher, and Novolog is even higher at $400 for a single vial. A box of five prefilled insulin pens may be upwards of $400 for Humalog Kwikpens and $700 for Novolog Flexpens.
Newer lower-cost versions are now available, with no insurance retail prices of:
- insulin lispro: $43 per vial
- insulin lispro pens: $192 per box
- insulin aspart vial: $174
- insulin aspart pens: $339
Some pharmacies — as a policy or by state law — don’t divide up boxes to dispense individually.
These are snapshots of general cash prices, with actual prices varying based on where you live, the pharmacy you use, and if you use any discount or perks programs. This does not factor in any insurance coverage you may have for insulin or diabetes medications.
Prices
With insurance coverage, the answer to how much insulin costs may be different for everyone and be based on many factors:
- the insurance company you have
- your specific plan details
- whether you have a deductible to pay before insulin coverage begins
- the type of insulin you take and whether that’s “preferred” or “not in formulary”
- how much insulin you take
- whether it’s through the Affordable Care and Prevention Act (ACA), which may include different requirements than private commercial plans
- if you’re on Medicare, which has capped insulin copays at $35 in recent years
While prices rose significantly as people were exposed to them more between 2009 and 2021, that pricing bubble finally
Some people with employer-based health insurance have also experienced $0 insulin copays for certain types of insulin, including the newer generic-like versions that are now available and have lower prices attached.
With Medicare and some insurance plans, insulin may be lower cost.
Starting in 2021, a new Medicare pilot program that had been years in the making by diabetes advocates led to $35 insulin co-pays for certain plans offered through the Centers for Medicaid and Medicaid Services (CMS).
The “Senior Savings Model” initially applied only to Part D prescription drug beneficiaries and affected only a small number of Medicare beneficiaries. It was originally an opt-in that required Medicare beneficiaries to voluntarily sign up for specific plans that offered this $35 insulin benefit.
However, the Inflation Reduction Act made that $35 insulin copay cap permanent starting in 2023.
It made the $35 insulin copay a requirement for all plans, applying to both Medicare Parts B and D, and removing all deductibles for the covered insulin. This meant people no longer needed to know enough to opt in for this lower copay benefit.
This only means that certain insulins that Medicare vendors approve are part of the discount program, which means people may need to discuss changing the brand of insulin they use to allow for the $35 insulin Medicare coverage.
That requirement remains in effect as of mid-2025, and starting in 2026, some seniors may pay less than $35 on covered insulins.
What is “Walmart insulin” for $35?
The phrase “Wal-Mart insulin” was once used to describe types of insulin available at the low cost store for less expensive prices. Traditionally, this was limited to older human insulin, which was first introduced in the 1980s. It’s known mostly in different forms of Humulin and Novolin brands.
However, this insulin does not work the same as more modern analogue insulins like Humalog and Novolog, and medical professionals advise against switching between newer and older insulins.
In recent years, Wal-Mart began selling Novolog insulin at lower prices. It is sold in stores for $35 or less under the ReliOn brand.
Insulin became expensive as a byproduct of the complex way the prescription drug and healthcare system runs in the United States.
This pits rising medical costs against the business practices of pharmaceutical companies, insurance companies, and pharmacy benefit managers (PBMs) who decide what is covered and how by how much.
Insulin prices had been rising in the mid-2000s, but with the insurance reforms that came with the ACA in 2010, more of that final price that had been hidden from people buying medications became more visible.
The rise of high deductible health plans (HDHPs) helped expose more people to higher insulin prices, and with the rebate system tied to pharma, insurers, and PBMs, companies hiked their list prices to bring in more profit.
All of this led to higher point-of-sale costs for people buying insulin, which, for those with type 1 diabetes, is a requirement to live.
This led to the insulin pricing crisis in the United States, which became political fodder for more than a decade and reached the White House and State of the Union discussions more than once through the years.
Eventually, a combination of factors led to incremental change. That included newer, lower cost insulin, insurance reforms, and more access for people with and without insurance to get certain insulins.
States have led the charge on taking real action on insulin affordability in the past decade.
Multiple states have enacted copay caps on insulin for those with insurance, aiming to help in some way.
Although copay caps have limitations, as they certainly don’t apply to everyone with insurance and have their own red tape, they at least have the potential to help.
There is no generic insulin in the same way that other generic medications exist.
For insulin, there are
Think of it as water from the same main source flowing out of the same faucet but into different bottles with different labels.
In the insulin universe, the 2 fast-acting authorized generics are:
- Eli Lilly’s Insulin Lispro, which is the same as the company’s brand name Humalog (which also has the scientific “insulin lispro name).
- Novo Nordisk’s insulin aspart, the same as the company’s brand name Novolog (which also shares the scientific “insulin apart” name).
These new insulins, along with other regulatory and systemic reforms, have helped lower the price of insulin for some people in recent years.
Some options exist for insulin if you are having difficulty affording or accessing what you need. These may include:
- Walmart: As noted, you can find some $35 or lower-priced insulin at this store. It’s sold under the ReliOn brand. If you’re currently using a modern insulin like Humalog or Novolog, make sure to discuss with your doctor what the ReliOn version of Novolog might mean for you.
- Emergency refills: Some insurance companies or pharmacies may allow for immediate refills on insulin. This might entail having a valid prescription for insulin on file. Rules may vary based on where you live or what your insurance plan allows for.
- Doctor offices: Some diabetes clinicians may have extra samples in their offices. While this is not a long-term solution, it could help if you’re waiting for other help to get insulin.
- GetInsulin.org: This diabetes advocate-led resource provides a one-stop hub for information on how to get access to more affordable insulin. Sponsored by insulin manufacturers, this online tool has guides and instructions on finding help if you need it.
- Pharmaceutical Patient Assistance Programs (PAPs): Each of the big insulin makers has financial assistance programs in place to help eligible people get insulin at a lower cost. They have certain restrictions and limitations, and each one may take time to apply and determine eligibility before you receive needed insulin. You are able to speak with someone at the particular Pharma company who can help guide you through the process.
- Discount programs: You might also find other discounts or coupon-like offers to help pay for insulin. These might come from places like Optum Perks, for example.
What is #insulin4all?With the insulin affordability crisis in America, a growing black market has materialized where people within the community regularly donate various types of insulin to each other directly or through grassroots efforts.
The Food and Drug Administration (FDA) doesn’t allow sharing prescription medications or supplies with those who did not receive the prescription from the doctor.
However, a
late 2019 study recognizes this reality and encourages clinics and doctors to be aware of these underground networks to understand their patients’ resources and potential risks.
Yes, insulin costs more in other countries.
This is largely due to the fact that some countries have universal coverage for all, and the fact that the U.S. health insurance industry usually leads to much higher prices because of multiple stakeholders, pharmacy benefit managers, and costs.
In this early 2024 report on a price index analysis, insulin prices in the United States were often 5 to 10 times higher than in other countries.
Americans have turned to other countries for years to get affordable insulin, Canada and Mexico in particular.
While that’s technically illegal, there’s been a long-standing FDA policy not to interfere as long as the insulin brought in is only for personal use, and not for resale. People at U.S. borders have traditionally not been questioned for personal supplies of insulin, including in the years after the pandemic.
During the pandemic, with closed borders, people with diabetes were not able to travel abroad for insulin in the same way they had. That pushed more people toward the private underground exchanges.
Insulin can be expensive for people without or with insurance.
However, there are many ways to find help if you can’t afford or access the insulin you’ve been prescribed. Those may include talking with your doctor for samples or applying for a discount program for lower cost insulin. You might also check for lower cost insulin options at a nearby pharmacy.
Always consult your healthcare team if you cannot afford or access insulin and if you are worried about not being able to take the amount they’ve prescribed. Do not switch insulins without first talking with your doctor and diabetes care team.