Novo Nordisk has told government and global nonprofits that it plans to significantly downsize its manufacturing of some of its insulin pens, according to one of the groups, and will transition a portion of its global supply to insulin vials and syringes that are easier to make but less convenient for patients.
The company’s plans were disclosed in recent discussions with Doctors Without Borders, who described them to Endpoints News, as well as the WHO, the Australian government, and other governments and regulators.
“We are not halting production of insulin in pens,” Novo said in an email to Endpoints. “In some cases, we will no longer make human insulin available in pens. It will be made available in a vial and disposable syringe.”
While some countries, like Australia and South Africa, are now seeking alternatives, the full extent of Novo’s plans isn’t immediately clear.
The company declined to comment further to Endpoints on exactly which markets would be affected. And it said that some — but not all — insulin pens would be affected by the shift. And it emphasized that the changes would happen slowly, over a period of years.
While South Africa in June announced shortages of insulin pens due to Novo’s decision to deprioritize their manufacture and supply, Doctors Without Borders’ pharmacist coordinator Christina Cepuch told Endpoints Friday that the latest announcement would go much further, based on the company’s comments to the groups. Geneva-based Doctors Without Borders is also known as Médecins Sans Frontières, or MSF.
The WHO lists Novo’s insulin pens on its essential medicines list, and will also have to find alternatives, Cepuch said. The WHO did not immediately respond to a request for comment.
“What does the WHO do about this? There’s not going to be any left. I mean, Lilly makes these, but they don’t make large volumes,” Cepuch said. “And what is WHO going to tell member states? Change everyone to glargine pens or go back to vials?”
Glargine is a form of long-acting insulin, and Novo is currently in the process of phasing out its own long-acting insulin, called Levemir.
On Tuesday, the Therapeutic Goods Administration, Australia’s drug regulator, released a short notice saying Novo will discontinue “some of its earlier generation insulin products” over the next two years. Scant on details, the notice said Australia is looking into alternatives.
Novo emphasized to Endpoints that it is expanding its overall drug manufacturing significantly with the acquisition of Catalent and other new investments.
Earlier this week, the Danish company’s CEO Lars Fruergaard Jørgensen testified before the US Senate at a hearing on drug prices and was asked by Sen. Tammy Baldwin (D-WI) about its insulin manufacturing plans. Baldwin asked Jørgensen if he would commit to “continue to have a focus on providing critical insulin. You will not reduce your manufacturing capacity in that area.”
“The world market for insulin is actually declining, so there’s less demand,” Jørgensen responded. “But we are committed to supply to the patient that has been using our insulin for years also into the future.”
Cepuch suggested that the company might decide to use freed-up pen capacity for its GLP-1 obesity products, which are also in shortage, or other insulins. Novo said the insulin and GLP-1 pens are different.