We welcome access to analogue insulin pens as they are the standard of care, but for them to be available for everyone, they must be affordably priced at US$1 – equivalent to R18 – per pen, especially considering the cost of production for insulin pens is estimated to be as low as $0.94 (R16,78) per pen, including a profit.
Last year, when Novo Nordisk stopped its production of easy-to-use human insulin pens, it severely impacted people with diabetes in South Africa. Many people were forced to change how they administered their lifesaving insulin from pens, which are often preferred by people with diabetes due to ease of dosing, reduced stigma, and therefore increased adherence and better health outcomes, to the more cumbersome vials and syringes.
Novo Nordisk’s supply commitment therefore fails to appropriately address the harm caused by the withdrawal of human insulin pens from the market, as although analogue insulin pens will now be available, the high price tag of $3.95 (R70,49) will not result in equitable access for everyone with diabetes in South Africa.
All insulin pens must be available at $1 (R17,84) per pen, so that everyone can access the highest standard of diabetes treatment.
Background:
Insulin pens are the standard of care in many high-income countries and, for people with diabetes, insulin pens are often preferred over more difficult-to-use vials and syringes. In South Africa, where diabetes is a leading cause of death, insulin pens have been available since 2014.
However, in 2024, Novo Nordisk – one of the world’s largest insulin manufacturers and South Africa’s main human insulin pen supplier – announced they would stop the production of human insulin pens altogether. This resulted in a shortage of insulin pens in South Africa, and many people had to switch to insulin vials and syringes.
In response, the South African government was forced to procure more expensive analogue insulin pens from another corporation. However, South Africa’s demand could not be met which, combined with the higher price tag, meant that not everyone who needed them had access to insulin pens.
Following Novo Nordisk’s abrupt decision to cease the production of human insulin pens, MSF and partner organisations pressured the corporation to address the gap in supply of insulin pens in South Africa. South Africa’s National Department of Health recently published its new supply contract for insulin devices, in which Novo Nordisk commits to supply analogue insulin pens at US$3.95 (R70.41) per pen, but this price per pen is too high.
MSF welcomes the move to analogue insulin pens, if they are priced affordably. While insulin analogues are similar to human insulins in their basic structures, they have been modified to change their onset and duration of action after injection, enabling greater flexibility of use for people living with diabetes.
With data published by MSF in the Journal of the American Medical Association (JAMA) estimating that insulin pens could cost as little as $0.94 (16,76) per pen to produce, including a profit, all insulin manufacturers should be pricing insulin pens at a dollar each.
Inclusive, equitable, cost-effective, and efficient healthcare, including for non-communicable diseases like diabetes, is a key objective of South Africa’s G20 Health Working Group. Failing to secure a more affordable price in today’s tender outcome represents a missed opportunity to adequately address price as a barrier to accessing insulin pens.
[ NB: The currency was changed on 12 June 2025. ]
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