MSF, Doctors Without Borders, Access to diabetes treatment
Diabetes

Pharmaceutical corporations must make essential diabetes medicines affordable and accessible

  • Pharmaceutical corporations Eli Lilly, Novo Nordisk, and Sanofi must take urgent action to increase access to diabetes treatment.
  • Pharmaceutical corporations sell newer diabetes drugs at up to 40,000% markup, while half of people with type 2 diabetes who need insulin don’t have access. 
  • Diabetes affects 537 million people globally. It is not just a disease of high-income countries: cases are rising in low- and middle-income countries, with a projected increase of 134% in Africa by 2045. 

On Wednesday, September 25, the US Senate Committee on Health, Education, Labour and Pensions held a hearing on 'why Novo Nordisk is charging outrageously high prices for diabetes medicines.' 

Doctors Without Borders (MSF) called on pharmaceutical corporations Eli Lilly, Novo Nordisk, and Sanofi in open letters to take urgent action to increase access to diabetes treatment everywhere by dropping prices and not blocking generic manufacturers from entering the market to help meet the global demand for these lifesaving treatments.

Currently, Eli Lilly, Novo Nordisk, and Sanofi control and monopolise the diabetes market** and so can set prices as high as they want, effectively blocking affordable access to diabetes treatment around the world, particularly in humanitarian and low-resource settings. 

MSF, Doctors Without Borders, access to diabetes treatemnt
20-year-old Idilo lwas diagnosed with Type 1 diabetes when she was 9. She needs to inject insulin twice daily.
Paul Odongo/MSF
The corporations making diabetes medicines have profited enough: our research has shown that the prices of insulin pens and new diabetes medicines are astronomically marked up at the expense of people living with diabetes being able to access lifesaving treatment. Christa Cepuch, pharmacist coordinator at MSF’s Access Campaign

“Every day, we witness a lack of access to insulin pens and newer diabetes medicines in countries where we work because prices are unaffordable and there is no sustainable supply,” said Christa Cepuch, pharmacist coordinator at MSF’s Access Campaign. “The corporations making diabetes medicines have profited enough: our research has shown that the prices of insulin pens and new diabetes medicines are astronomically marked up at the expense of people living with diabetes being able to access lifesaving treatment.”

A study published in March 2024 by MSF in the Journal of the American Medical Association (JAMA) Network, reveals the stark contrast between the estimated cost of production with a profit (the ‘cost-based price’) and the actual pharmaceutical profiteering on insulin pens and newer diabetes medicines.

MSF, Doctors Without Borders, access to diabetes treatemnt
Current market prices and pharma markups.

Long-acting analogue insulin pens, for example, are sold for US$2.98 (R51.25) in South Africa, $7.88 (R135.60) in  India and $28.40 (R488.83) in the US, compared to the possible cost-based price of $1.30 (R22.38) per pen, and GLP-1 medicines (e.g. Ozempic) are sold at a nearly 40,000% markup in the US, while remaining largely unavailable in low- and middle-income countries: A one-month supply could be sold at a profit for just $0.89 (R15.35) per month, yet costs $115 (1,979.32) per month in South Africa, $230 (R3,985.65) in Latvia, and  $353 (R6,076.05) in the US. 

Additionally, Eli Lilly and Novo Nordisk are the only producers of this newer GLP-1 receptor agonist class of medicine used to treat people with diabetes. The high prices these corporations charge are partly due to patent monopolies on the drugs and the devices that deliver them, blocking generic manufacturers from entering the market, which could help drive prices down. For example, competition among generic pharmaceutical manufacturers is what brought the cost of HIV medicines down by 99% over the past two decades. Having additional manufacturers in the market would also help meet the global supply needs for these new pen-device medicines, which Eli Lilly and Novo Nordisk cannot do alone.

MSF, Doctors Without Borders, Access to diabetes treatment
Lowest annual cost-based prices for a person with type one diabetes.

“[The] Senate Hearing [asked] pharmaceutical corporations a basic question: what makes it acceptable to charge extraordinarily high prices for lifesaving medicines when they cost just a few dollars to produce?” said Mihir Mankad, director of global health advocacy and policy at MSF USA. “We urge Novo Nordisk, as well as Eli Lilly and Sanofi, to put people before profits by dropping the price of the diabetes medicines they produce, and allowing more manufacturers around the world to make them so there is enough supply for all people who need them."

[*Figures are based on the exchange rate from Wednesday, 25 September 2024]