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The phenomenon has been called the scourge of urban life: an unhealthy lifestyle and obesity have resulted in a recrudescence of type 2 diabetes, which occurs when the body can not produce enough of a kind. insulin to regulate blood sugar. .
About 33 million people who need to Insulin in the world do not have access to the drug
Scientists now claim that millions of diabetics worldwide may not be able to access insulin over the next decade – and perhaps even longer.
About 400 million people aged 20 to 79 live with type 2 diabetes, the most common form of the disease. More than half of them in China, India and the United States. By 2030, it is estimated that the number exceeds 500 million. The other form of diabetes is type 1, in which the body attacks pancreatic cells producing insulin.
A new study published in the journal Scientific Lancet Diabetes and Endocrinology indicates that about 80 million diabetics will need insulin by 2030. But about half of these patients will have diabetes. Between them – probably most in Asia and Africa – will not succeed. Currently, one in two people with type 2 diabetes does not have access to the insulin it needs.
"Access (to insulin) is defined as the combination of product availability and affordability," said Dr. Sanjay Basu of Stanford University to the United States. States, which coordinated the research. "In addition to the price problem, there must also be a supply chain capable of safely delivering a refrigerated medicine and all that goes with it, such as needles and sterile needles."
Why is insulin, a 97-year-old drug that was once considered one of the revolutionary drugs of the twentieth century, still very expensive over the years?
One of the reasons, say the scientists, is that three multinational companies (Novo Nordisk, Eli Lilly and Company, Sanofi) control 96% of the volume of insulin sold worldwide and 99% of the estimated sales value of 21 billions of dollars.
Overall Control
Although more than 90 countries out of 132 do not apply insulin levels, the drug remains very expensive for many people.
Even in the United States, where more than 20 million patients have been diagnosed with diabetes, personal expenditure on insulin increased by 89% between 2000 and 2010. Even among adults enjoying health insurance . The price of the drug has gone from $ 40 to $ 130 – each bottle usually lasts a few weeks.
There are also considerations about the availability of the drug.
There are different types of insulin. And doctors prescribe the most beneficial type to each patient, depending on how they react to the drug, the type of life they lead, their age, their blood glucose goals, and the number of shots they give. that he takes every day.
Several low- and middle-income countries are particularly vulnerable to stock-outs. A study on the availability of insulin showed that stocks were low in six countries: Brazil, Bangladesh, Malawi, Nepal, Pakistan and Sri Lanka. In Mozambique, for example, 77% of the country's total insulin supply is in the capital, causing a shortage of medicine in other regions.
"Around the world, issues such as product availability and affordability threaten life and endanger the right to health," Beran said.
Why has a drug discovered so long ago by scientists at the University of Toronto still not available as a low-cost generic? (Scientists sold the patent to the university for $ 1). High-demand drugs often become more affordable once their patents expire, thanks to cheap competitors. But that was not the case.
One of the reasons, according to scientists Jeremy A Greene and Kevin Riggs, is that insulin is more complex and difficult to copy. And the generic drug companies considered that "it was not worth it". Insulin biosimilar, similar to insulin, is also available in the market, at more competitive prices, but does not have a generic version.
Scientists say insulin should be included in universal health coverage programs and global donors should allocate a portion of their funds to innovation in health care and to the drug itself even.
Evidently, weak health systems, limited access to health care facilities, diabetes care and prices impede access to insulin.
"Few things have to happen, including pricing and distribution infrastructure," Basu explained. Until then, the injection of insulin should not be more accessible.
The Basics of Diabetes
– There are two main types of diabetes – type 1 and type 2. There is also gestational diabetes that can occur during pregnancy.
In type 1, which is usually diagnosed early in life but can appear at any age, insulin must be injected. This is not preventable or curable and is not caused by lifestyle.
– People develop type 2 when the insulin that they produce does not work properly or when it is insufficiently produced. This may be due to the fact that the person is overweight, inactive or also has a family history. It is much more common than type 1, accounting for 90% of all people with diabetes. Some people with type 2 take insulin, while others control their blood sugar with the help of medication, exercise and a healthier diet.
– Failure to control blood glucose in the long term can lead to complications such as nerve, kidney, eye and foot problems, but the risk can be reduced with appropriate treatment and care.
Sources: NHS (British Health System) Diabetes UK
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