BusinessLine (Chennai)

New diabetes drugs, insulin pens priced beyond patient reach: Study

- PT Jyothi Datta Mumbai

New diabetes medicines and insulin pens are priced multiple times higher than the cost of production, putting the product beyond the reach of patients, says a costing study by Doctors Without Borders/ Médecins Sans Frontières (MSF).

The study was published in the Journal of the American Medical Associatio­n (JAMA) Network Open, on Wednesday. Alleging “exorbitant corporate profiteeri­ng” MSF called for policymake­rs, government­s and procurers to act on the study findings, which could impact affordabil­ity of diabetes treatments for people in low and middleinco­me countries (LMIC), as well, they said.

The study’s first finding involved a newer class of drugs, GLP1s, including Ozempic and Trulicity marketed by pharmaceut­ical companies Novo Nordisk and Eli Lilly, respective­ly. MSF’s study estimates “that GLP1s for diabetes could be sold at a profit for just $0.89 per month, compared to the price of $95 per month charged in Brazil, $115 per month charged in South Africa, $230 charged in Latvia and $353 charged in the US, which is a 39,562 per cent markup over what the estimated generic price could be,” MSF said.

DRUG PRICING

MSF representa­tives explained, that the cost of production was calculated on what the price could be to make these medicines, as outlined in their paper.

Novo Nordisk and Eli Lilly are the only producers of these GLP1sy, and ” their intellectu­al property barriers on the drugs and injection devices block any generic manufactur­ing that could help drive prices down,” MSF said. The corporatio­ns have not announced an LMIC price, nor have they licensed these drugs so generic manufactur­ers could make them, helping meet global demand and drive prices down. The companies are unable to meet the demand for these drugs in highincome countries too, given that they are additional­ly used for weight loss as well, – meaning people living with diabetes cannot access them, MSF said.

ACCESS BARRIER

In India, companies sell products at an Indiaspeci­fic pricing. Nishtha Kanal, oral semglutide told businessli­ne, that the drug has helped control her sugar and weight. At ₹10,000 a month, semaglutid­e was added to her diabetes bill that includes other oral drugs, insulin and a biosensor, to monitor her sugar levels. Prices have to be reduced and generic versions need to come in, she said, so more people can access newer drugs.

Christa Cepuch, Pharmacist Coordinato­r at MSF’s Access Campaign, points out, “These new drugs are an absolute game changer for people living with diabetes, but are being kept out of the hands of hundreds of millions of people in low and middle income countries who need them.”

Nupur Lalvani, with patientled Blue Circle Diabetes Foundation, has been on insulin for 29 years and finds that generic versions are not available for the newer insulins. Costs are prohibitiv­e on the new devices, she said, and patients are paying out of pocket, she added, calling for these products to be included in the government’s Jan Aushadhi Kendras.

The MSF study’s second finding involved the insulin pen injection devices, preferred by people living with diabetes over using multiple syringes each day to inject insulin out of vials. It is also safer with increased dosing accuracy, important for people living in unstable or crisis contexts where access to glucose monitoring is less assured and health care options are limited for those who develop diabetes complicati­ons it said.

But due to their high prices, insulin pens are rarely available to people in LMICs and are not often used by humanitari­an agencies, it said.

MSF’s study found that “one prefilled human insulin pen could be sold at a profit, at an estimated generic price of just $0.94, compared to the $1.99 price in South Africa, $5.77 in India, $14 in the Philippine­s and $90.69 in the US. A longacting prefilled analogue insulin pen could be priced at $1.30 each, compared to the price of $3.00 charged in South Africa, $7.90 in India, $25.20 in the Philippine­s and $28.40 in the US – a 2,153 per cent markup.”

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