Interview with Dr. Ur: Once Weekly Insulin
Dr. Ur was recently interviewed by The Canadian Press about Novo Nordisk’s announcement of a new once weekly insulin.
Dr. Ur was quoted saying “the new weekly insulin is "another tool in the toolbox" for treating diabetes -- but many patients may not be able to access it due to cost.”
I wanted to get some clarity about who would benefit from a once weekly insulin and what those benefits would be from Dr. Ur’s perspective.
Before we get to Dr. Ur’s answers, I think its important to get a bit of background information to better understand Dr. Ur’s statement.
We know in Canada, insulin prices are low because our pubic health system controls drug prices through the Patented Medicines Pricing Review Board.
Insulin was discovered in the 1920’s by Frederick Banting. Banting was a morally ethical man and sold his discovery to the university of Toronto for $1 to ensure that people would have access to this life-saving discovery.
A lot has changed since the 1920’s and there are several types of insulin and delivery systems on the market which have their own patents - From ultra long-acting to short acting, different concentrations and different pens .
Insulin manufacturers say the price increases are justified by the innovation — creating more effective and convenient insulin formulations for patients. This is a fair point and certainly there is a cost to innovation. These drug companies are for profit and their fiduciary responsibility is to their shareholders, not the public. This is why a public healthcare system or a public healthcare program is so important. Our government negotiates and ensures the prices for these life-saving therapies are not exploitive.
In 2018 the average American insulin user spent $3490.00 on insulin compared to $725.00 among Canadians. (1) Thats almost 5 times as much per insulin user. Many people who require insulin ration their insulin doses in order to keep the costs lower but this isn’t a solution.
In the last couple of years, there has been a huge amount of pressure for the American government to do something about the price gauging happening in the US. For example, only a couple of years ago, there were reports of insulin costing 10x more per vial in the US than in Canada. Finally, congress heard the voices of their people and created the Inflation Reduction Act. Now there are several companies who are offering insulin for $35 a month for those who are on Medicare or who do not have insurance. They have even lowered their prices for pre-filed pens in some cases over 70%.
These interviews are done by recording and are transcribed here for you.
If you would like to hear the recordings for these interview, please let us know and we will begin to upload them for your listening ease.
Felicia:
Dr. Ur, we know this new medication is going be more expensive than the daily insulin vials and pens. Hopefully, private insurance companies will cover these medications for their plan holders but whether they do or they don’t, can you tell us who would benefit from a once weekly insulin dose?
Dr. Ur:
The first thing to note, is that a once weekly insulin is primarily for people wit Type 2 Diabetes. There may be some cases where a weekly injection is suitable for someone with Type 1 Diabetes but again, this innovation is primarily for people living with Type 2 Diabetes.
A once weekly insulin is a huge breakthrough and can be especially beneficial for those who have poor adherance.
Many patients struggle with the daily routine of insulin injections, leading to missed doses and poor glucose control. A once-weekly insulin dose can significantly improve adherence by reducing the frequency of injections.
There is also the matter of convenience. A weekly injection can greatly improve the quality of life for people with busy schedules or those who find daily injections burdensome. This can lead to a more consistent management of their condition.
And by reducing the frequency of injections can also alleviate the psychological burden and anxiety associated with daily insulin use, leading to better overall mental well-being.
Felicia:
So, how can people who use insulin assess whether it’s right for them?
Dr. Ur:
The first step is contemplation - Think about whether changing to a once weekly injection is what’s best for you. The next step would be to speak with your Family Doctor or Endocrinologist to see if you are a good candidate for once weekly insulin.
Felicia:
As always, it’s been a pleasure, Dr. Ur.
Dr. Ur:
Pleasure is all mine.
(1) Schneider T, Gomes T, Hayes KN, Suda KJ, Tadrous M. Comparisons of Insulin Spending and Price Between Canada and the United States. Mayo Clin Proc. 2022 Mar;97(3):573-578. doi: 10.1016/j.mayocp.2021.11.028. Epub 2022 Feb 5. PMID: 35135692.