Insulin, Human Isophane (NPH) Shortage Update: What Patients Need to Know in 2026

If you take NPH insulin — Humulin N, Novolin N, or Walmart's ReliOn Novolin N — and have been struggling to fill your prescription consistently, you may be wondering whether there is an official shortage. Here is the current situation as of 2026, explained clearly for patients.

Current NPH Insulin Shortage Status (2026)

As of 2026, there is no active, nationwide FDA-designated shortage of standalone NPH insulin (Humulin N or Novolin N). Both Eli Lilly and Novo Nordisk have maintained overall supply, and the over-the-counter ReliOn Novolin N at Walmart continues to be available in most locations.

However, in 2024, the American Society of Health-System Pharmacists (ASHP) did issue a shortage bulletin for combination insulin NPH and regular human products — and localized, pharmacy-level stockouts of standalone NPH have been reported intermittently throughout 2024-2025. These regional shortages are distinct from an FDA national shortage but can be just as disruptive for patients.

NPH Insulin Shortage History: A Brief Timeline

• 1946: NPH insulin first developed by Hans Christian Hagedorn.
• 1982/1991: Human recombinant NPH (Humulin N, Novolin N) approved by FDA.
• 2020: Insulin isophane was the 221st most prescribed medication in the US with over 2 million prescriptions.
• 2024: Inflation Reduction Act $35/month Medicare insulin cap takes full effect. ASHP issues shortage bulletin for combination NPH+Regular products. Localized NPH stockouts reported nationally.
• 2025-2026: Supply of Humulin N and Novolin N generally stable at the national level. ReliOn NPH at Walmart remains the most consistently available OTC option. No active FDA shortage listing for standalone NPH.

Why Patients Still Struggle to Find NPH Insulin

Even without an official national shortage, patients regularly report difficulty finding NPH insulin for several reasons:

• Demand shifts: When other basal insulins (like Tresiba/degludec or Semglee/glargine) face shortage, some patients and providers fall back to NPH, temporarily straining local NPH inventory.
• Cold chain logistics: Insulin is a biologic requiring refrigerated storage and transportation. Any breakdown in the cold chain — from manufacturer to distributor to pharmacy — can cause localized shortages.
• Market consolidation: As pharmacies reduce overhead, some are stocking fewer NPH SKUs — meaning vials may be available but pens are not, or one brand is stocked but not the other.
• Insurance formulary changes: Some plans have shifted preferred formulary status away from NPH toward long-acting analogs, reducing pharmacy incentive to keep NPH well-stocked.

What the NPH Shortage Situation Means for You

Here are the practical steps to protect yourself in the current environment:

1. Refill early: Don't wait until your last vial. Start calling pharmacies 7-10 days before you need a refill.
2. Know your OTC backup: ReliOn Novolin N at Walmart is approximately $25/vial and does not require a prescription. In most stock situations, at least one Walmart near you will have it.
3. Use medfinder: medfinder calls pharmacies near you to check real-time stock on your behalf. This is far more efficient than calling pharmacies yourself one by one.
4. Talk to your doctor about long-term alternatives: If NPH is consistently difficult to find in your area, ask your prescriber whether switching to a long-acting analog like insulin glargine (Basaglar, Lantus) makes sense for you clinically and financially.

Will the NPH Insulin Supply Situation Improve?

The outlook for NPH insulin supply in 2026 is generally stable. Both Eli Lilly and Novo Nordisk have no announced plans to discontinue their NPH products. The Walmart ReliOn program provides a consistent low-cost OTC safety net. The greater near-term supply risks in the insulin category are with newer analogs (glargine biosimilars, degludec) rather than traditional NPH.

If you're struggling to find your NPH insulin today, medfinder.com can help by checking pharmacy stock near you quickly and efficiently. You deserve access to your medication — let medfinder do the calling for you.