More than a century has passed since insulin was first used to treat diabetes.

Yet in 2026, one basic fact has not changed enough:

Needing insulin does not necessarily mean being able to access the insulin, cartridge, or insulin pen that a patient actually uses.

For some people, the main problem is cost. For others, it is insurance coverage, local supply shortages, discontinuation of a particular insulin presentation, or simply the fact that the compatible reusable insulin pen is no longer stocked by local pharmacies.

These differences help explain why patients are increasingly looking beyond their usual local pharmacy and searching online for specific insulin pens, cartridges, and related diabetes supplies.

However, the issue is more complicated than simply saying that “online shopping is more convenient.”

Global data show that insulin access itself remains deeply uneven.

Insulin Access Remains a Global Problem

The World Health Organization estimates that approximately 9 million people worldwide live with type 1 diabetes and require insulin.

In addition, around 60 million people with type 2 diabetes need insulin to achieve optimal glycemic control.

Yet only about 50% of those people with type 2 diabetes are able to access the insulin they need.

This is especially important because insulin is not an optional treatment for people with type 1 diabetes. It is essential for survival.

WHO data also show that diabetes treatment gaps remain particularly severe in lower- and middle-income countries. In 2022, almost 450 million adults aged 30 and older with diabetes were not receiving treatment, representing approximately 59% of adults with diabetes worldwide. Around 90% of those untreated adults were living in low- and middle-income countries.

In other words, the global diabetes problem is not simply about whether effective treatments exist.

They do.

The problem is whether people can actually obtain them.

The Gap Is Not Only Between Rich and Poor Countries

It would be easy to assume that insulin access problems occur only in low-income countries.

Recent research suggests otherwise.

A 2025 study published in JAMA Network Open examined insulin and diabetes technology access across 81 diabetes centers in 56 countries, representing more than 42,000 children with type 1 diabetes.

Only 32 participating centers, representing 19 countries, reported full availability and reimbursement for all surveyed diabetes technologies and insulin.

Eight participating countries reported no reimbursement for any of the surveyed technologies or insulin.

Even within higher-income regions, reimbursement structures varied.

The study reported full insulin reimbursement across the participating European countries, Australia, and New Zealand, but greater variation across Asia, the Americas, and Africa.

For example, participating centers reported:

• full insulin reimbursement in countries including Hong Kong, Taiwan, Thailand and Türkiye

• limited reimbursement in Iran and South Korea

• out-of-pocket insulin purchasing in India

• reliance on sponsorship in Nepal and Pakistan

• insurance-related copayments in parts of the United States and Canada.

The study also found an association between access and glycemic outcomes.

Children treated at centers reporting full insulin reimbursement had a mean HbA1c of approximately 7.75%, compared with 10.49% in the category where insulin was available only through sponsorship or was unavailable.

Because this was a cross-sectional study, the result does not prove that reimbursement alone caused the difference. But it clearly illustrates how access to diabetes treatment and health outcomes can be closely connected.

Affordability Is Still a Major Barrier

Cost remains one of the most persistent problems.

In May 2026, WHO reported that its South-East Asia Region has an estimated annual demand of approximately 170 million insulin vials.

The organization noted that prices ranging from roughly US$6 to US$20 per vial remain prohibitive for millions of vulnerable patients in the region.

This illustrates why insulin affordability cannot be evaluated simply by looking at the absolute price of one vial.

The real burden depends on income, insurance coverage, the amount of insulin required every month, access to glucose-monitoring supplies, medical consultations, needles, cartridges and the delivery device itself.

For a person managing diabetes every day, all of these costs accumulate.

But “Insulin Availability” Does Not Always Mean the Right Product Is Available

There is another issue that is becoming increasingly important.

A country may technically have insulin available while a specific formulation, cartridge, pre-filled pen, or reusable pen system is unavailable.

This distinction matters.

People who have used the same insulin delivery system for years may be accustomed to a particular device, dosing mechanism, cartridge format or dose increment.

When one presentation disappears from the market, simply telling a patient that “the insulin is still available” does not necessarily mean that nothing has changed.

Recent developments in the UK provide a clear example.

Diabetes UK reported that Fiasp FlexTouch pre-filled pens have been discontinued and are now out of stock, while Fiasp Penfill cartridges remain available.

Tresiba FlexTouch pre-filled pens have also been discontinued while the cartridge presentation remains available.

NovoRapid FlexTouch pens were similarly discontinued, while other NovoRapid pen and cartridge formats remain available.

This means that the active insulin may still exist, but the delivery format a patient previously used may no longer be available.

The Same Pattern Is Appearing in Other Countries

Australia is seeing similar changes.

The Therapeutic Goods Administration reported in 2026 that Novo Nordisk and Eli Lilly were discontinuing a number of insulin products and presentations.

The TGA specifically noted that in many cases, while one presentation disappears, the same medicine may remain available in another format — for example, a vial may be replaced by a cartridge or pre-filled pen.

Affected products include various presentations of:

• Fiasp

• Ryzodeg

• Levemir

• Humalog

• Humulin

• Protaphane

• Actrapid.

The European Union has also experienced presentation-specific supply problems.

The European Medicines Agency reported that shortages of Insulin Lispro Sanofi cartridges and pre-filled pens were expected in some EU/EEA countries beginning in the first quarter of 2026, while the vial presentation was not affected.

Once again, the important distinction is:

The medicine may still exist, while the exact format the patient needs may not.

Why Reusable Insulin Pens Are Becoming More Important

Changes in insulin packaging can also create demand for reusable insulin pens.

A particularly relevant example is the HumaPen Savvio.

In the UK, following discontinuation of certain Humulin vial presentations, healthcare professionals were advised that 3 mL Penfill cartridges compatible with the HumaPen Savvio reusable insulin pen remained available and could support increased demand.

Similar guidance was issued for Humalog Mix25 cartridges.

This is an important change in how we should think about insulin access.

Access does not only mean:

“Can the patient obtain insulin?”

It can also mean:

“Can the patient obtain a compatible device that allows them to use the insulin presentation currently available?”

That is a very different question.

And it helps explain why someone may suddenly begin searching online for a HumaPen Savvio, another reusable insulin pen, or a specific compatible device even though insulin itself is still available locally.

When the Cartridge Is Available but the Pen Is Not

Patient communities also illustrate this problem.

In a recent discussion on Reddit's type 1 diabetes community, one user described moving to China and successfully purchasing prescribed Humalog cartridges from a pharmacy.

The problem was that local pharmacies did not carry the compatible reusable pen.

The user then began searching online for the appropriate reusable insulin pen.

A single Reddit post is obviously not evidence of global demand.

But it is a useful real-world example of a problem that official supply data also demonstrate:

Access to insulin and access to the correct delivery device do not always occur together.

This mismatch can push patients to search outside their normal local pharmacy network.

Why Patients Search for Insulin Pens Online

There is currently no comprehensive global database showing exactly how much online insulin pen purchasing has increased.

So it would be inaccurate to claim that a particular percentage of patients have moved from local pharmacies to online pharmacies.

What the available evidence does show is that several conditions that encourage online searching are happening at the same time.

1. Local availability varies widely

A specific pen or cartridge may be readily available in one country and difficult to find in another.

2. Manufacturers are changing product presentations

A pre-filled pen may disappear while the cartridge remains available, or a vial may be discontinued while a pen version continues.

3. Patients often need a specific compatible device

Reusable insulin pens are not universally interchangeable.

A cartridge must be used with an appropriate compatible pen system.

4. Patients may prefer a device they already know how to use

Changing insulin delivery devices can require retraining.

Diabetes UK specifically recommends that patients switching to a new injection pen receive instruction from a healthcare professional and confirm that they have all necessary equipment before using the new device.

5. Online search makes geographically fragmented supply easier to investigate

When a product cannot be found locally, the internet allows patients to search pharmacies and medical suppliers across a much wider geographical area.

That does not automatically mean an overseas purchase is legal, safe or appropriate — but it explains why the search often begins online.

Insulin Pens Are Not All Interchangeable

One of the most important points for patients searching for insulin pens online is compatibility.

A reusable insulin pen is a medical delivery device designed for particular cartridges.

Patients should never assume that a cartridge will work simply because it physically resembles another cartridge.

The insulin formulation, cartridge design, pen mechanism, dose increments and manufacturer instructions all matter.

This is particularly important for patients who need features such as:

• half-unit dosing

• memory functions

• specific cartridge compatibility

• reusable rather than disposable designs

• particular dose capacities.

Buying the wrong pen can result in a device that cannot safely or accurately administer the prescribed insulin.

Buying Insulin Products Online Requires Extra Caution

Online access can increase choice, but insulin-related products require more care than ordinary consumer products.

Patients should verify whether an online pharmacy or medical supplier is appropriately licensed for their jurisdiction.

If the product contains insulin, several additional factors become important:

Prescription requirements:
Insulin and prescription requirements differ by country. Patients should follow the laws and medical requirements of the destination country.

Storage and temperature control:
Insulin is a temperature-sensitive biological medicine. Shipping and storage requirements must be followed carefully.

Product authenticity:
Patients should avoid unidentified sellers or products whose manufacturer, batch information or origin cannot be verified.

Compatibility:
Reusable pens should be matched only with cartridges for which they are designed.

Medical guidance:
Changing insulin type, dose or delivery device should be discussed with an appropriate healthcare professional.

Online availability should never replace proper medical supervision.

Global Insulin Access Is Really Several Different Problems

When discussing insulin access, it is tempting to reduce everything to one issue.

But the evidence suggests that patients may actually face several different access problems:

Can I afford the insulin?

Will my insurance reimburse it?

Is the insulin available in my country?

Is my preferred formulation still manufactured?

Is the cartridge available?

Is the compatible reusable pen available?

Can my local pharmacy obtain it?

A patient may have a positive answer to some of these questions and a negative answer to others.

That is why insulin access can remain difficult even in markets where insulin itself has not disappeared.

What This Means for HumaPen and Other Reusable Pen Users

For users of systems such as HumaPen Savvio, availability of the reusable pen becomes particularly important when compatible cartridges remain part of the local insulin supply.

The UK situation illustrates this clearly: certain Humulin and Humalog presentations have changed, while Penfill cartridges designed for reusable delivery systems remain part of the alternative supply pathway.

This can create situations where the cartridge is available but a patient still needs to locate the correct reusable pen.

For patients who already know and use a particular pen system, finding the same device may also be preferable to learning a completely different delivery mechanism.

However, patients should always confirm cartridge compatibility and follow professional guidance before changing devices.

The Bigger Picture

The discovery of insulin transformed diabetes from a rapidly fatal condition into a manageable chronic disease.

But more than 100 years later, universal access remains unfinished.

WHO has made 100% access to affordable insulin and blood-glucose self-monitoring for people with type 1 diabetes one of the global diabetes coverage targets.

The fact that this remains an international target in 2026 demonstrates how much work is still required.

At the same time, the meaning of “access” is changing.

It is no longer enough to ask whether insulin exists somewhere in the healthcare system.

Modern diabetes care also depends on access to:

• the right insulin formulation

• the correct cartridge

• a compatible insulin pen

• glucose-monitoring equipment

• needles and other supplies

• reliable medical support.

When any one of these pieces is missing, patients begin looking for alternatives.

Increasingly, that search starts online.

Final Thoughts

The growing interest in buying or sourcing insulin pens through online pharmacies should not be viewed simply as a trend toward online shopping.

In many cases, it reflects a much larger healthcare problem.

Global insulin access remains unequal. Reimbursement differs dramatically between countries. Individual insulin presentations are being discontinued or temporarily unavailable. And patients may find that the insulin they need is still available while the specific pen or delivery system they are accustomed to using is not.

For reusable insulin pen users, this distinction can be particularly important.

A cartridge without a compatible delivery device is not a complete solution.

At Zarvy Pharm, we believe patients should have access to clear information about insulin pens, cartridge compatibility, product availability and the differences between reusable and pre-filled systems.

Understanding those differences is becoming increasingly important as the global insulin market continues to change.