(Bloomberg) -- About 400 people marched to the South African headquarters of Novo Nordisk A/S in Johannesburg this week demanding greater access to its human insulin and lower prices, while also protesting against the Danish company’s recent decision to phase out easy-to-use pens to deliver the diabetes medication.
For Janice Barnes, one of the demonstrators who has lived with diabetes for more than 43 years, no pens will mean carrying around a glass vial with a syringe to ensure treatment — something that turns the clock back more than three decades and comes as the disease has skyrocketed, she said.
“In South Africa, we pretty much all have family that is affected,” Barnes said.
The protest in South Africa may be a harbinger of other displays of anger against the company, as the perception grows that a focus on its blockbuster weight-loss treatment means it’s giving short shrift to medications like insulin for diabetes — something Novo vehemently denies. The phasing out of pens for human insulin, an older form of the drug, comes as Novo boosts the production of another type of diabetes medicine, the appetite-reducing shot sold as Ozempic.
Trouble is, Novo’s best-selling weight-loss treatment Wegovy, which has faced shortages, is the same as Ozempic, but at a different dose, and some doctors have prescribed the diabetes-fighting drug off-label to their overweight patients. Novo’s Ozempic and Wegovy pens are produced at some of the same plants that make insulin pens.
“It is important to highlight the global shortage of insulin pen sets, likely due to an increased demand of more profitable products and manufacturers prioritising their production over insulin pen sets,” Diabetes South Africa, an organization that supports people with the disease, said in its official magazine in September. In response to emailed questions, Novo said its weight-loss medications are not delivered via the same pens as the insulin.
The row over insulin access, price and the eventual discontinuation of pens comes against a backdrop of rising cases of the disease worldwide. The number of people with diabetes — that most may have to live with for the rest of their lives — has doubled over the past 30 years to almost 830 million. The fastest increase is in low- and middle-income countries.
South Africa is becoming a flash point. Diabetes is the leading underlying cause of death among women in the country, which has overburdened public facilities that currently serve about 84% of the population. The remaining 16% who can afford private insurance often have access to world-class treatment.
Novo will respond in writing to the protesters’ demands by Dec. 13, a South African company representative said.
Growing obesity rates are fueling the prevalence of type 2 diabetes, where the body can’t properly use the insulin it produces. Still, there are many like Barnes with type 1 diabetes, where the body makes little to no insulin. Not taking insulin would leave the person at risk of falling into a coma or other life-threatening complications that result from dangerously high blood sugar levels.
For now, making insulin locally may help ease the crunch. Aspen Pharmacare Holdings Ltd., based in Durban, is pushing into diabetes care, with a contract to make Novo’s human insulin. Africa’s biggest drugmaker also has an agreement with Eli Lilly & Co.’s to distribute and promote its blockbuster diabetes drug Mounjaro throughout Southern Africa. Ultimately the plan is for Aspen to make the product itself.
Barnes knows she is among the fortunate few in South Africa with private medical insurance. Still, she struggles to get a constant glucose monitor covered through her 6,000-rand a month ($330) insurance, and she is paying a further 2,000 rand a month for her diabetes care.
“Most people can’t afford that,” said Barnes, carrying a placard calling for insulin pens at $1 a piece, down from $3 currently.
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