Marketing of insulin – a missed opportunity
16th December 2010
The Insulin Dependent Diabetes Trust [IDDT] comments that the Channel 4 News item [15.12.10] successfully highlighted the huge waste of valuable NHS funds, tax payers’ money, on the prescribing of newer synthetic insulins which have no proven benefits for the vast majority of people needing insulin treatment. It did point out that if half of those taking analogue insulins had been prescribed so-called human insulin, £250 million could have been saved over the last 5 years – money which could have been spent on better care for patients, for example, by removing the restrictions on essential blood glucose test strips or employing more specialist nurses to provide more and better education for people with diabetes.
The programme missed a valuable opportunity to address some very key issues. IDDT would like to know how the pharmaceutical companies have managed to persuade the NHS, doctors and nurses to prescribe very costly analogue insulins that have no proven benefits for the vast majority of patients? NICE guidance quite clearly states that analogue insulins should not be the first choice of insulin, so why has NICE guidance been ignored by prescribers and PCTs, who are usually only too ready to restrict spending on glucose test strips and other drugs? It is insufficient to say that insulin analogues have been ‘oversold’. The public need to know what marketing techniques are employed to cause prescribers to ignore evidence from research and subsequently make prescribing decisions that are not necessarily in the best interests of patients, the NHS or the taxpayer?
But most importantly, the programme did not address the fact that the long-term safety and efficacy have not been proved for insulin analogues. For one long-acting insulin at least, the European Medicines Agency has stated that ‘they cannot deny or confirm’ that there is an increased risk of tumours developing and more research is needed. If health professionals provided their patients with the truly informed choice of insulins to which they are entitled, would they really choose analogue insulins?
Jenny Hirst, Co-Chair of IDDT commented, “We heard the insulin manufacturers telling us that analogue insulins are better. Many health professionals believe they are better despite the lack of evidence from research. However, this was not balanced by any discussions about risks and adverse reactions, nor was there a patient perspective. Ultimately patients are the consumers and can be the victims of drug company policies!”
She continued, “IDDT believes that Channel 4 missed a valuable opportunity to investigate many issues that are the key to good healthcare. It is not simply about cost but as NICE advises, it is about cost effectiveness. People with diabetes need individualised treatment to suit their needs and to provide the best quality of life. This means being given an informed choice of treatment, including information about risks and benefits and the long-term safety of the various types of insulin, synthetic human, analogue and natural animal insulin.”
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