Localising diabetes management solutions with PodTech™

The diabetes burden in LMICs.

According to the International Diabetes Federation (IDF), there were 164,400 adult cases of diabetes in Burkina Faso in 2021.

Nigeria, with a larger overall population, had 3,623,500 adults with diabetes in 2021.

In Kenya, the number stood at 821,500.

In Côte d’Ivoire, it was 231,200.

The world over, diabetes has been claiming more and more lives. For the first time, in 2019, diabetes entered the list of top 10 causes of death worldwide; the World Health Organisation (WHO) indicated that that year, diabetes-related deaths increased by 70% since 2000.

Diabetes is often considered a disease of affluence, but it is anything but. A study published in The Lancet notes that of the 463 million adults worldwide living with diabetes, about 80% reside in low and middle income countries (LMICs). To make matters worse, fewer than one in 10 people with diabetes in LMICs receive comprehensive diabetes treatment based on accepted global guidelines. In Africa, only one in 7 people who live with type 1 diabetes and need insulin have access to it.

The problem isn’t a lack of research or innovations in the field of diabetes treatment. Rather, it is pricing and inequitable access to diagnostics and essential medicines which compound the problem in LMICs.

In the 10 LMICs with the highest diabetes prevalence, research has shown that improving diagnosis and access to essential medicines can have a transformational effect on diabetes-related mortality rates. As many as 800,000 premature deaths could be prevented annually if the right interventions are taken.

The right interventions: insulin pen devices, long-acting insulin, and GLP-1 agonists.

Along with long-acting insulin, insulin pen devices are included in the WHO’s Essential Medicines List. Insulin pens are already the standard of care in high-income countries. Compared to vials and syringes, they are safer, more practical, easier to use, and less painful than other similar tools. Additionally, the pens make it easier to administer the correct dose and users find it less stigmatizing to use in public.

A paediatrician for Doctors Without Borders has spoken about the transformational impact of deploying these pens in Lebanon. They claim that offering insulin pens to people with diabetes significantly enhanced their quality of life. In the case of children with diabetes, insulin pens made it more likely that they would stick to their treatment schedules.

Largely, insulin pens are preferred to the traditional syringes and needles used to administer insulin. The numbers speak for themselves: Doctors Without Borders and T1International surveyed 400 insulin users across 38 countries – users who had tried both pens and the syringe/needle alternative – to find that 82% preferred the pens.

Additionally, shiny new diabetes treatments like Eli Lilly and Novo Nordisk’s GLP-1 receptor agonists have also shown impressive results in managing diabetes. For instance, along with diet and exercise, Novo Nordisk’s Ozempic is proven to improve blood sugar in adults with type 2 diabetes.

Price is a barrier…

As we’ve already mentioned, a lack of research or scientific advancements is not the problem. Then what is?

Human insulin in a vial with syringes has been considered to be the most affordable diabetes management option. For this reason, it is usually the only option offered to patients in LMICs or humanitarian emergencies.

Long-acting insulin pens are sold for $2.98 in South Africa, $7.88 in India, and $28.40 in the USA. In poorer countries, these pens are pretty much out of reach of the common man.

Meanwhile, GLP-1 agonists cost astronomical amounts wherever they are available. $115 per month in South Africa, $230 in Latvia, $353 in the USA. Since Eli Lilly, Novo Nordisk, and Sanofi are the only companies selling cutting-edge drugs in the diabetes space right now, their intellectual property barriers prevent the entry of generic manufacturers. The lack of generics manufacturers means that there’s no one to drive down the prices of this important class of drugs.

… but it doesn’t have to be.

Insulin with vials and syringes is considered the cheapest option for diabetes management, but it doesn’t have to be. Research by Doctors Without Borders has shown that long-acting insulin pens – which are safer and more practical than the alternative – could be sold at a profit for as little as $111 per patient per year. That is a whole 30% less than the cost of insulin in a vial with syringes.

Insulin pens cost $2.98. $7.88, and $28.40 in South Africa, India, and the USA, respectively, but the cost-based price of the pen is only $1.30.

Meanwhile, the GLP-1 drug semaglutide could be sold at a profit for as little as $0.89 per month. The current prices at which it is sold go as much as 40,000% higher than the estimated price of generics.

In short, extremely high markups are making diabetes treatments inaccessible to patients in LMICs. Intellectual property barriers, which block the entry of generic manufacturers into the market, keep prices sky-high. They also sustain a supply-demand mismatch, which, at present, is keeping GLP-1s out of reach of many who could benefit from them.

Leveraging local manufacturing to plug access gaps.

Inadequate access to insulin pen devices, long-acting insulin, and innovative new diabetes treatments can be addressed with local biopharmaceutical manufacturing and tech transfer and licensing agreements.

If Nigeria were to produce long-acting insulin, while Ghana manufactured insulin pens… the West African region could become self-sufficient in providing diabetes management solutions to its population. Imagine well-equipped diagnostic centres in every part of Uganda, diabetes-focused R&D facilities in Kenya, licensing agreements to make GLP-1 receptor agonists in Zimbabwe… diabetes management could be transformed in every part of the African continent.

These visions aren’t mere dreams; they are possibilities that can be realised. Possibilities for transforming healthcare access and chronic disease management in regions that have historically been burdened with complex epidemiology and poor health infrastructure.

PodTech™, with its prefabricated pharma factory systems – podules™, can bring these possibilities to life. Quickly installed modular construction, fully equipped cleanroom systems, and robust engineering – the podules™ encompass everything a project would need to hit the ground running.

Well, what are you waiting for? There is no time to lose – join hands with PodTech™ today to make equitable global healthcare a reality.