NovoLog Mix 70/30 Shortage: What Providers and Prescribers Need to Know in 2026

If your patients are reporting difficulty filling NovoLog Mix 70/30 prescriptions, the data confirms what they're experiencing. The insulin aspart protamine/insulin aspart mix product remains on the ASHP drug shortage list as of early 2026, driven by manufacturing discontinuations and distribution challenges. This briefing covers the prescribing and clinical implications, along with workflow strategies to help your patients navigate the shortage.

Current Supply Status (As of Early 2026)

• NovoLog Mix 70/30 FlexPen: Available but with intermittent constraints at high-volume retail pharmacies. Independent and specialty pharmacies tend to have better availability.
• Unbranded insulin aspart protamine/insulin aspart: Novo Nordisk discontinued all unbranded versions effective December 31, 2025. Remaining pharmacy inventory may still exist but is depleting.
• NovoLog Mix 70/30 vials: The unbranded 10 mL vial and 3 mL pen injector were designated "To Be Discontinued" as of July 2025. Update standing orders accordingly.

Prescribing Implications: What to Change

Given the discontinuation of unbranded forms, providers should take the following prescribing steps:

1. Update prescription language. Prescriptions that do not specify "FlexPen" may be rejected or unfillable at pharmacies. Explicitly specify "NovoLog Mix 70/30 FlexPen" rather than generic form.
2. Review standing EHR orders and refill templates. Any auto-refill logic or order sets that reference discontinued NDC codes should be updated to avoid failed fills.
3. Proactively discuss backup plans. For patients with a history of fill difficulty, document an alternative therapy plan in the chart so the care team can act quickly without a provider callback.

Clinically Appropriate Alternatives

When NovoLog Mix 70/30 cannot be located, the following substitution strategies are clinically appropriate:

• Humalog Mix 75/25 (insulin lispro protamine/insulin lispro): Closest pharmacodynamic analog. Ratio difference (75/25 vs 70/30) is clinically minor for most patients. One-to-one unit substitution is generally appropriate but close monitoring is advised at transition.
• Basal-bolus transition: For appropriate patients, transitioning to a long-acting insulin (glargine, degludec, detemir) plus a rapid-acting insulin at meals provides more flexibility and better glycemic control. Total daily dose can be maintained with appropriate distribution. Increased SMBG frequency during transition is recommended.
• Novolin 70/30 or Humulin 70/30: For short-term bridging in patients with type 2 diabetes, human premixed insulin may be used, keeping in mind the 30-45 minute pre-meal administration requirement and slower onset/offset. Dose adjustment may be needed.

Biosimilar Insulin Aspart: What Prescribers Need to Know

Two biosimilar rapid-acting insulin aspart products are now approved and entering the market:

• Merilog (insulin aspart-szjj, Sanofi): FDA-approved February 2025; biosimilar (not interchangeable); distribution expanding.
• Kirsty (insulin aspart-xjhz, Biocon/Viatris): FDA-approved July 2025 as the first interchangeable biosimilar to NovoLog; can be substituted at pharmacy level without prescriber involvement in states that allow it. Market launch underway.

Important: these are rapid-acting components only. There is not yet an approved biosimilar for the NovoLog Mix 70/30 premixed combination.

Patient Affordability: What Has Changed in 2026

Novo Nordisk's price reductions, effective January 1, 2026, significantly lower the barrier for commercially uninsured patients:

• List price: ~$72.34/vial, ~$139.71/FlexPen pack
• Novo Nordisk savings card: as little as $35/month with commercial insurance (max savings $65/fill)
• My Insulin Rx: $35/month with no insurance required (up to 3 vials or 2 packs of pens)
• Medicare Part D: $35/month insulin cap under the Inflation Reduction Act
• Patient Assistance Program: free insulin for eligible uninsured patients with limited income (call 1-866-310-7549)

Helping Patients Locate Stock: medfinder for Providers

If your patients are struggling to fill their prescriptions, medfinder can help. Patients provide their medication, dosage, and ZIP code. medfinder contacts pharmacies on their behalf and texts them which locations have it in stock. This reduces the burden on your front desk staff fielding pharmacy callbacks and helps patients avoid dangerous lapses in insulin supply.

For a complete guide on how to help patients locate NovoLog Mix 70/30, see: How to Help Your Patients Find NovoLog Mix 70/30 in Stock: A Provider's Guide.