NEW YORK/GENEVA/JOHANNESBURG, November 12, 2024 — Ahead of World Diabetes Day on Thursday, Doctors Without Borders/Médecins Sans Frontières (MSF) called on all insulin manufacturers to make insulin pen injection devices available at $1 per pen everywhere, including in low- and middle-income countries and humanitarian settings where people’s access is currently extremely limited.
This call, aimed at Eli Lilly, Novo Nordisk, Sanofi, and all other insulin manufacturers, is based on data published by MSF in the Journal of the American Medical Association (JAMA) Network Open estimating that insulin pens could cost as little as $0.94 per pen to produce and still be profitable for the companies. Instead, pens are currently priced at $1.99 in South Africa, $5.77 in India, $14.00 in the Philippines, and $90.69 in the US. Eli Lilly, Novo Nordisk, and Sanofi control and monopolize the diabetes market so can set prices as high as they want.
“Over 100 years ago, the scientists who discovered insulin wanted everyone with diabetes to have access to treatment, so they sold the patent for just $1,” said Dr. Helen Bygrave, non-communicable diseases advisor for MSF’s Access Campaign. “But, since then, something’s gone seriously wrong because now only about half of people around the world who need insulin can access it. It’s devastating that today pharmaceutical corporations Eli Lilly, Novo Nordisk, and Sanofi are maintaining this double standard in access to diabetes care.”
Insulin pens are essential medicine
Insulin pens, which were originally developed over 40 years ago by a doctor to help her daughter's diabetes management, are the standard of care in high-income countries. However, high prices and the lack of other manufacturers often keep insulin pens out of reach for people in humanitarian and low-resource settings even though they are safer and easier to use than syringes and vials of insulin. A survey by MSF and T1International highlighted that insulin injected from pen devices is preferred by 82 percent of people with diabetes over insulin in vials due to its accuracy, ease of dosing, and reduced stigma. Pens can improve quality of life for people with diabetes and are now included in the World Health Organization (WHO) Model List of Essential Medicines.
Novo Nordisk recently announced that it will soon halt the production of insulin pens, making it even more difficult for people to access these medicines. The company is withdrawing its production of insulin pens so they can produce and sell more of their patented GLP-1 medicine for diabetes and obesity (marketed as Ozempic and Wegovy) in pen devices at markedly high prices in high-income countries. Because of this, many people with diabetes may have to make significant treatment adjustments, and some will be forced to change to using insulin in vials with syringes. For example, people with diabetes in South Africa—which pioneered a shift towards the use of insulin pens in the public sector by replacing insulin in vials with pens in 2014—had to ration insulin pens earlier this year when Novo Nordisk stopped selling human insulin pens to the South African government.
“Everyone living with diabetes deserves access to the highest standard of treatment and care, and the fact that insulin pens are virtually unavailable in low- and middle-income countries due to high prices is a glaring and unacceptable double standard,” said Candice Sehoma, advocacy advisor for MSF’s Access Campaign. “With Novo Nordisk’s withdrawal from the insulin pen market, we demand they and other insulin manufacturers make all types of insulin pens available at $1, especially considering that their cost of production is estimated to be as low as $0.94 per pen, including a profit. It’s time to put an end to profiteering on this lifesaving medicine that has been around for more than a century."
Diabetes around the world
Diabetes affects 537 million people globally and cases are rising in low- and middle-income countries, with a projected increase of 134 percent in Africa by 2045. MSF has significantly increased the number of diabetes consultations in its medical programs. In 2022 alone, MSF performed 205,122 diabetes-related consultations globally.
