The old formulas you can buy OTC for $25 are more inconvenient to use, but will indeed keep you from dying. The main difference between the R insulin and Novolog/Humalog are how quickly they act. Novolog starts lowering your glucose in about 60 minutes while the R takes 2 hours. Dietary management is not related to which insulin you’re using. So yes, the claim that OOP’s only alternative to paying $800 was to die is not true.