Kristóf is a global advocate with T1International, from Hungary, who participated in T1International’s New Advocate Speakers Bureau in January 2026.

In November 2025, Novo Nordisk announced it would discontinue several insulins across Europe, including in Hungary where I’m from. For many of people, it had a significant disruption. I know this because I lived it.

When I was diagnosed with diabetes in 2022, I was prescribed Fiasp, one of the most modern, ultra-rapid acting insulins available and which had been introduced commercially the same year. It immediately became a part of my daily routine and something I relied on to manage my blood sugar and to live a normal and active life (I am a member of an association for athletic diabetics). I believed it would be that way forever. Then, suddenly, Fiasp was gone.

This wasn’t the first time I’ve had to switch insulins. I had to switch to Novorapid for a few months due to prolonged shortages. But this wasn’t a temporary disruption, it was a permanent withdrawal. And it forced me to confront an uncomfortable reality: the insulin I need to continue my normal life exists at the mercy of corporate priorities.

This realization pushed me to join T1international earlier this year by participating in the New Advocates Speakers Bureau. What’s happening in Hungary is not an isolated issue but rather part of a global pattern.

Insulin access in Hungary

When the Canadian Frederick Banting discovered insulin in 1923, he donated its patent to the world for a symbolic one dollar. Since then, humanity has witnessed countless new developments and discoveries. These technological advancements are especially important for those of us living with diabetes. But access is still largely controlled by just three corporations: Sanofi, Novo Nordisk, Eli Lilly. And this oligopoly doesn’t just influence price but also determines availability.

In Hungary, we are very fortunate. Insulin and diabetes supplies are heavily subsidized through the public healthcare system. A significant role in supporting people with diabetes was played by the country’s former president, whose child also has type 1 diabetes. While there is a shortage of specialized nurses and diabetologists, regional disparities in the quality of services, and a lack of psychological support, we know that we are generally very fortunate. For many patients, cost is not the primary barrier. Access is. All insulin in Hungary is imported. That means when a multinational corporation changes its strategy, patients are impacted. And we and our government have no control over it.

As part of a global portfolio reduction, Novo Nordisk is withdrawing six insulin products (Actrapid, Insulatard, Levemir, Fiasp, Novorapid, Novomix 30) from the market across the EU. In an interview I held with Novo Nordisk’s Hungarian representatives, the company’s medical director cited supply reliability and pandemic-related disruptions. But there’s another side to the story. While reducing insulin options, the company has simultaneously expanded production capacity for newer, more profitable drugs: GLP-1 therapies for weight loss and other care. The message is hard to ignore: when resources are limited, profitability shapes priorities.

And for patients like me, the consequences are immediate. Fiasp is not interchangeable with other insulins although most doctors switched their patients to Novorapid with Fiasp’s discontinuation. Fiasp acts faster, requires different timing and allows for more flexibility, especially for people who live active lives like me. Switching to rapid-acting Novorapid as an alternative means relearning how to eat, move and manage glucose, and can lead to worse blood glucose levels and reduced Time in Range results.

The hidden cost of dependence

The withdrawal of insulin Fiasp exposes a much larger problem: dependence. Hungary’s diabetes care system is strong in many ways but it rests entirely on external supply chains. There is no domestic insulin production, no public manufacturing fallback, and no mechanism to ensure continuity when private companies withdraw products. Patients are left to adapt, absorb the consequences and hope for the best.

But it doesn’t have to be this way. Around the world, governments are beginning to rethink their dependence on private pharmaceutical monopolies. Public Pharma offers an alternative model where essential medicines are produced in the public interest, not driven solely by profit.

Hungary and the European Union could follow the examples of Brazil and California, which have begun producing their own insulins. This not only makes insulin cheaper but also a more predictable supply for patients. I believe it is time to replace global hegemony with a human-centered approach, and profit-driven thinking with empathy.

Conclusion

Novo Nordisk’s decision is not unprecedented; when a company discontinues a life-sustaining medication, patients are not a part of the decision-making but are impacted by the consequences. The need to take action against Big Pharma, to achieve independence and predictability, is not only an individual interest but a societal one as well. Countries must act, either independently or together, against violations of patient rights and the disregard of the fundamental rights of people with diabetes to create a world where diabetes is associated not with death and fear, but with life and security.

Who should control access to essential medicines? Who could decide over the head of patients? The availability of essential medicines like insulin cannot depend solely on corporate decisions. My experience with the situation in Hungary with Fiasp’s discontinuation leads me to call for Public Pharma.