Novel insulin products: Why would patients, professionals and industry want them?

Authors

  • Vicky Stokes Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford, UK
  • Kavitha Sebastian Rozario Paediatric Endocrinology, John Radcliffe Hospital, Oxford, UK.
  • Jyothis George Boehringer Ingelheim Ltd, Bracknell, UK; Warwick Medical School, University of Warwick, Coventry, UK; Diabetes and Endocrinology, Royal Berkshire Hospital, Reading, UK

DOI:

https://doi.org/10.15277/bjd.2016.110

Keywords:

insulin, biosimilar, glycaemic control

Abstract

Multiple innovations over a century have improved the safety, tolerability and clinical acceptability of insulin. From a therapeutic option that required multiple injections a day, often with a poor predictability, insulin has evolved into a treatment approach that an empowered patient can self-administer safely. It is the most potent glucose-lowering therapy and has hence seen widespread clinical adoption in the last two decades in the treatment of type 2 diabetes.

At the same time, the unit-costs of insulin have not declined as is often the case with long established therapies. We review the history of insulin as a drug, charting its course from early experiments to modern insulin therapies. We consider the need (or lack thereof) for novel insulin from the perspectives of patients, healthcare professionals and healthcare payers.

Whilst there are many valid arguments to support the development of novel insulins, healthcare systems and payers will require a clear demonstration of value for any novel insulin product. If a premium price (i.e. a higher price than comparable products) is demanded by manufacturers, healthcare payers would rightly seek evidence of added value – this could involve clear markers of increased safety and efficacy and/or the offsetting of other diabetes-related costs.

References

Greene JA, Riggs KR. Why is there no generic insulin? Historical origins of a modern problem. N Engl J Med 2015;372:1171–5. http://dx.doi.org/10.1056/NEJMms1411398

PM Live website. http://www.pmlive.com/top_pharma_list/pharmaceutical_products/lantus

Conterno E. For some diabetics, a struggle to pay for insulin. New York Times, 29 Feb 2016

Gough S, Russell-Jones D, Millar P, Sumner J. Re: Big changes led to big profits for insulin manufacturers (rapid response). BMJ 21 Jan 2011. http://www.bmj.com/content/341/bmj.c7139/rapid-responses

International Diabetes Federation. IDF Diabetes Atlas. 7th Edition. http://www.diabetesatlas.org/

Diabetes UK. The Cost of Diabetes Report. 2014. https://www. diabetes.org.uk/Documents/Diabetes%20UK%20Cost%20of%20Diabetes%20Report.pdf

Gan & Lee Pharmaceuticals website. http://www.ganlee.com/en/index.php?page=2

Owens DR, Landgraf W, Schmidt A, Bretzel RG, Kuhlmann MK. The emergence of biosimilar insulin preparations – a cause for concern? Diabetes Technol Ther 2012;14:989-96. http://dx.doi.org/10.1089/ dia.2012.0105

Gough S. Biosimilar insulins: opportunities and challenges. Practical Diabetes 2013;30:146-7. http://dx.doi.org/10.1002/pdi.1763

Biocon Pharmaceuticals website. http://www.biocon.com/biocon_products_bio_BF_basalog_mp.asp

Basalin (2015). MIMS. Retrieved from www.mims.com

Lantus (2015). BNF 61.

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Published

2016-12-20

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