Doctors Without Borders (MSF) is calling on Eli Lilly, Novo Nordisk and Sanofi to immediately reduce the price of insulin pens to $1 per device in low- and middle-income countries (LMICs).
Pens are the main way insulin is administered in many wealthy countries. The devices accounted for 59% of the U.S. market and 94% of the European market in 2020. Uptake of insulin pens in LMICs is lower. A 2019 survey found 17% of diabetes centers in LMICs were using pens. Syringes remained the dominant delivery format and almost all countries reused needles.
There is evidence people in LMICs want to use pens. A survey by MSF, which attracted responses from 38 countries including Bolivia, India, Panama and the U.S., found 82% of people with diabetes prefer pens over insulin in vials injected with syringes. People who favor pens cited accuracy, ease of dosing and reduced stigma as the reasons for their preference.
MSF has identified price as a barrier to the use of insulin pens in LMICs. The nonprofit published a paper on insulin pen prices in March, in which it said the devices cost $1.99 in South Africa, $5.77 in India and $14.00 in the Philippines. The LMIC prices are cheaper than the U.S., where MSF said companies charge $90.69 per pen, but the nonprofit made the case they could be lower.
According to MSF, a prefilled human insulin pen could be sold at a profit at an estimated generic target price of just $0.94. The estimate informed the call for Lilly, Novo, Sanofi and other insulin suppliers to sell insulin pens for $1.
The call for a $1 price is the latest in a series of actions by MSF focused on insulin pens. The nonprofit put the insulin price data at the center of a paper titled “Defeating the double standard in diabetes care” earlier this year. And it turned up the heat on Novo when the Danish drugmaker outlined plans to stop making human insulin pens. Novo is continuing to supply its newer generation insulins in pens.