MSF calls out Novo Nordisk for its double standard approach to diabetes, as corporation plans to halt supply of human insulin pens  

Geneva, 20 September 2024: In a significant setback for people with diabetes in humanitarian and resource-poor settings, Médecins Sans Frontières (MSF) and several other stakeholders were notified last week by the Danish pharmaceutical corporation Novo Nordisk that it will soon halt the production of human insulin* pens, because of a supply constraint with pen devices, but that it will scale up production of human insulin in vials that people then have to inject with syringes. This move will allow the corporation to produce and sell more of their patented GLP-1 medicine for diabetes and obesity (marketed as Ozempic and Wegovy) in pen devices at high prices in high-income countries. ​ The corporation is now worth half a trillion dollars. ​ ​ ​ 

A survey by MSF and T1International highlights that insulin injected from pen devices is preferred by 82% of people with diabetes over insulin injected with syringes due to its accuracy, ease of dosing, and reduced stigma. Pens improve the quality of life for people with diabetes and are now included in the World Health Organization (WHO) Model List of Essential Medicines. Despite their advantages, insulin pens remain largely inaccessible for most people with diabetes in low- and middle-income countries. But that could change with affordable pricing and supply. Recent data published by MSF in the Journal of the American Medical Association (JAMA) estimates that insulin pens could cost as little as US$0.93 per pen, including a profit. ​ 

As a medical humanitarian organisation, MSF has been calling for a sustainable supply of affordable insulin pens for people with diabetes in low- and middle-income countries. This decision by Novo Nordisk will further limit access to an essential and people-friendly method of insulin administration, and likely force people to change to syringes and vials in the absence of affordable analogue* insulin pens. ​ 

Countries like South Africa have been pioneering a shift towards the use of insulin pens in the public sector, replacing traditional vials for all patients with diabetes since 2014. However, South African patients with diabetes have faced insulin-pen rationing this year as Novo Nordisk opted not to bid in the tender to supply human insulin pens to the South African government. ​ Instead, the corporation has offered only the vial option, which is a major setback to South Africa’s efforts to improve diabetes treatment. In a recent development, the French corporation Sanofi has announced publicly that it is engaging with the South African Department of Health to supply analogue insulin pens at an affordable price. However, Sanofi has not announced the price at which it will offer these pens to South Africa. ​ MSF published a video recently sharing these concerns including some voices of people with diabetes in South Africa. ​

 The manufacture and supply of insulin, discovered over 100 years ago, has been dominated for decades by three corporations—Novo Nordisk, Eli Lilly, and Sanofi—which together control approximately 90% of the global insulin market. ​ Novo Nordisk has grown to become the largest corporation in Europe, while Eli Lilly is predicted to soon become a trillion-dollar corporation, benefiting from profits accrued through insulin sales and, more recently, from the GLP-1 receptor agonists for both diabetes and obesity. These medicines under patent monopolies are available in single-use pens and are sold at markups as high as 40,000% based on the JAMA study. 

Candice Sehoma, Advocacy Advisor for MSF’s Access Campaign 

 “We are alarmed by Novo Nordisk’s double standard shown toward people with diabetes in low- and middle-income countries. While the corporation continues to profit immensely by supplying newer, more expensive insulin and semaglutide pens (Ozempic and Wegovy) to wealthier nations, its decision to withdraw human insulin pens may push people with diabetes in resource-limited settings, who rely on insulin for survival, to revert to using vials and syringes, which virtually nobody uses anymore in high-income countries. Everyone living with diabetes deserves access to the highest standard of treatment and care. Novo Nordisk’s decision to limit insulin availability to vials in these countries ​ promotes unequal standards of care between patients in high-income countries and those in low and middle-come countries.” ​ 

“The other insulin manufacturers now have an opportunity to address this double standard that has long existed toward people with diabetes in low- and middle-income countries. We demand that Sanofi and other insulin manufacturers come forward and ensure the price of $1 each for all types of insulin pens, given that the cost of production is estimated to be as low as $0.93 per pen, including a profit. The profiteering on a lifesaving medicine that has been available for more than a century must stop now." 

*Insulin is classified as either human or analogue, and by its onset and duration of action. Insulin analogues, while similar to human insulins in their basic structures, have been modified to change their onset and duration of action after injection, enabling greater flexibility of use for people living with diabetes and– for some people – facilitating a reduction in episodes of hypoglycaemia (low blood sugar levels). 

For more information, please contact:

Shailly Gupta

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