Accessible Insulin
In 2022, Eli Lilly and Company became a corporate partner of the United Nations International Children’s Emergency Fund (UNICEF) with the aim of treating and preventing non-communicable diseases, such as diabetes, in young people globally. This four-year commitment aims to lower death rates and prevalence rates of ailments impacting children in low-and-middle-income countries. The pharmaceutical company has also acknowledged WHO’s Global Diabetes Compact, launched in 2021, and the WHO’s request for companies in the private sector to help further the goals of the compact. The compact’s key asks are to unite stakeholders, integrate better treatment and prevention worldwide (particularly in low-and-middle-income countries), innovate by “close[ing] priority research gaps,” track progress by setting targets, funding health care and educating about diabetes. With these goals in mind, Eli Lilly has made a push toward accessible insulin.

Eli Lilly and Company

Founded by Colonel Eli Lilly in 1876, Eli Lilly and Company has spent more than 145 years manufacturing medicines for the general public. The company has manufactured “commercial quantities of insulin” since the 1940s so that life-saving medicine for people with diabetes would become more widespread.

The company operates in close to 125 countries with 14 manufacturing sites worldwide. It offers products worldwide, with a presence in Africa, the Americas, Europe, the Middle East and various parts of Asia. While its headquarters are located in Indianapolis, it has subsidiaries in many countries, including Malaysia, Peru, Turkey, Austria and Israel.

Eli Lilly’s most notable product is its insulin. Humalog, also known as Insulin Lispro Injection, is a “fast-acting insulin” that the company sells. This insulin serves to control the high blood sugar levels of both children and adults. Eli Lilly also manufactures various cancer and immunology medicines, with more than 47 million people relying on its medication.

EVA Pharma Partnership

In December 2022, Eli Lilly partnered with EVA Pharma to manufacture and supply accessible insulin to low-and-middle-income countries. EVA Pharma products reach more than 40 countries and are made in facilities that are internationally known by organizations like the European Medicines Agency for “high-quality standards.”

Eli Lilly provided EVA Pharma with its API (active pharmaceutical ingredient) for insulin at a reduced price, alongside providing “pro-bono technical assistance.” The aim is for African-made insulin to be distributed within 18 months and for it to reach 1 million people by 2030, as part of the Lilly 30×30 initiative. The initiative pairs with external organizations like the Bill & Melinda Gates Foundation and aims to make quality health care more accessible for 30 million people in “limited-resource settings,” particularly in low-and-middle-income countries.

Price Cuts

In March 2023, Eli Lilly reduced the price of its insulin by 70%, dropping from $275 to a maximum of $35. Most notably, the company slashed the price of Humalog and its non-branded insulin. This occurred more than a year after China’s push for accessible insulin in 2021 when Eli Lilly reduced the price of insulin in China by 75%. During China’s push for more accessible insulin, Novo Nordisk and Sanofi cut their insulin prices by an average of 48%.

China’s VBP (volume-based procurement) goal in 2021 entailed providing consistent and lower pricing across the country for medication, particularly for medicine that had “outlived their exclusivity.” This centralized drug procurement program saved medical institutions ordering insulin an estimated 9 billion yuan. Another benefit of the program is the lowered price of insulin for patients with diabetes, thus making long-term use of this life-saving medication more affordable.

Impacts on Diabetic People in Developing Countries

A study by Anastasia A. Lam and others reports that, in 2019, 463 million people suffered from diabetes globally, and by 2045, this statistic could grow to 700 million. Furthermore, the study notes that 80% of those with diabetes live in low-and-middle-income countries. The International Diabetes Federation’s Diabetes Atlas projects a 129% increase in the prevalence of diabetes in Africa. This equates to 55 million people in one area of the world alone and showcases a dire need for accessible insulin.

The public has progressively become more invested in the insulin industry. While Eli Lilly has been involved in initiatives for accessible insulin for a couple of years, for instance, its partnership with UNICEF since February 2022, the public continues to become more scrutinous toward the pharmaceutical industry.

As a result of this, accessible insulin has become important for companies like Eli Lilly to stay afloat. The more accessible insulin that comes from a particular company, the higher the chance of other companies following suit. When a global environment is bred for high-quality and affordable health care, companies and countries face pressure to provide just that through actions as large as China’s national insulin procurement program or as small as the average person’s critique. Eli Lilly’s recent actions demonstrate a push toward more accessible health care for diabetics and paint an optimistic outlook for the future of health care.

– Lachlan Griffiths
Photo: Flickr