Doctors say a discussion with drugmakers is needed to boost production of simpler forms of the hormone to avoid leaving millions at risk of limb amputation, kidney failure and premature death. No generic or inexpensive form is available globally, they say.
Price Dialogue
The problem doesn’t necessarily lie with drugmakers, according to Novo. “There are challenges in the supply chain including high price mark-ups, which hinder people with diabetes from getting insulin at an affordable price,” Charlotte Ersbøll, vice president for corporate stakeholder engagement at the Bagsvaerd, Denmark-based company, said by telephone. “We are working with partners to find solutions.”
Insulin is only one cost diabetics incur. Patients also struggle for access to test strips to read their blood-sugar levels, pre-filled pens to inject the medicine and expert advice, according to Indianapolis-based Lilly. Like Paris-based Sanofi and Novo, the company has access programs in low-income countries. Sanofi, whose engineered insulin Lantus faces copycat challengers for the first time, says its focus is on innovative solutions that can represent a breakthrough for patients.
“We need to engage in a dialogue around pricing,” Etienne Krug, director of the WHO’s department for management of non-communicable diseases, disability, violence and injury prevention, said in an interview. The Geneva-based agency will seek to encourage pharmaceutical and diagnostics companies “to continue producing the cheapest versions of those medicines and tests” that are effective as well as to ensure that “they are widely disseminated,” he said.
Trillions in Losses
Insulin is big business, commanding global sales of $23 billion last year, with more than three quarters of that stemming from the new generation of products, according to Bloomberg Intelligence. Yet that amount is a fraction of the toll the diabetes epidemic may extract from economic growth, especially as the disease strikes younger people in their peak economic years. In one study cited by the WHO, costs both direct and indirect will lead to $1.7 trillion in gross domestic product losses from 2011 to 2030.
Most people suffer from a form of diabetes known as type 2, in which patients’ bodies become resistant to insulin or don’t produce enough to manage the level of sugar in the blood -- making some almost as dependent on the hormone as the rarer type 1 sufferers.