As a direct consequence of insulin price slashes - companies stopped making insulin.
There's been a shortage of Fiasp (insulin aspart) since July - it was supposed to be over by September. That deadline has now been extended to January. Fiasp is the fastest acting, (formerly premium) insulin on the market - it isn't complex (its just insulin aspart with some niacin and an amino acid) but it is patented - there is no generic.
Levemir is discontinued.
Insulin glargine/lantus is discontinued.
There are constant rolling shortages of most insulins on the market - you simply can't get them sometimes.
Manufacturing capacity has been diverted to ozempic and other weight loss drugs.
For a long time, I had a dream of living on a desolate mountain alone. Then, I had to start getting insulin just to stay alive. Okay, so I can't live on a desolate mountain - I have to have a pharmacy. But if SHTF there is no home remedy, there's no easy way to synth this stuff - its complex and difficult.
Shit hasn't hit the fan but they still just don't want to make it. While still having a corner on the market, patents, exclusivity deals, etc.. no other manufacturer is stepping up. The free market isn't working very well.
here's an article on market forces
https://www.statnews.com/2024/05/15/discontinuing-insulin-problematic-trailing-edge-older-versions-keep-it-affordable/