Insulin could slip down the priority list as drugmakers chase obesity market

A access-to-medicine watchdog warns that big firms' pivot to GLP-1 weight-loss drugs could erode insulin supply in poorer countries.

The Access to Medicine Foundation, a Netherlands-based non-profit part-funded by the UK and Dutch governments, has warned in its biennial report that the industry's focus on GLP-1 weight-loss drugs may pull attention away from diabetes treatments such as insulin. Chief executive Jay Iyer said Sanofi, Eli Lilly or Novo Nordisk could leave the insulin market, which would badly hurt supply for people with type 1 diabetes and insulin-dependent type 2 diabetes.

The arithmetic behind the worry is margin. Companies can charge much higher prices, and earn more, on weight-loss injections and pills than on insulin. An estimated 589 million adults worldwide have diabetes, and 81% of them live in low- and middle-income countries. GLP-1 drugs are not registered in many of those countries, and where they are sold, high prices and a lack of equitable pricing put them out of reach for most people. So the profitable new products do not substitute for insulin where it is needed most.

The pipeline is also lopsided: of 25 diabetes-area medicines in development, most target type 2 diabetes and only 10 target type 1. Novo Nordisk has announced plans to phase out some older diabetes products, including insulin pens. For abundance, this matters because insulin is a cheap, old, essential drug whose availability depends on makers choosing to keep supplying it. If commercial attention moves elsewhere, access gaps widen, and the burden falls on families and care systems.

The evidence is mixed, and the exit scenario is a warning, not an announced decision. Sanofi has broken ground on a new insulin site in Frankfurt; it supplies insulin to 15 million people in over 100 countries a year. Lilly won US approval in September for a once-weekly insulin injection for adults with type 2 diabetes. Novo said it would review the findings, including options to broaden access to analogue insulins and extend access plans to more low- and middle-income countries. Watch whether those commitments materialise, and whether any firm scales back insulin output.

Source: Guardian