A recent decision by Novo Nordisk to pull biphasic isophane insulin (Mixtard 30) from the U.K. drug market could slap on £9 million ($11.8 million U.S.) to the National Health Service (NHS) drug bills in England alone, according to an editorial published in the August issue of the Drug and Therapeutics Bulletin.
The decision to remove Mixtard 30 from U.K. shelves was for commercial reasons according to Novo, but the editorial said the decision could affect an estimated 90,000 patients.
Removing Mixtard 30 from the market will require diabetic patients to look for alternative biphasic analogue insulins, which are recommended by the National Institute for Health and Clinical Excellence (NICE) as the treatment of choice for diabetics; however, these alternatives are generally more expensive than Mixtard 30.
“This is quite apart from the extra resources needed to review patients to discuss and decide on alternative treatments, and the disruption and concern such changes may cause for affected individuals,” the editorial stated. “The withdrawal of Mixtard 30 will therefore have a major impact on patients, healthcare professionals and healthcare expenditure."
The decision to cut Mixtard will also mean that biphasic insulin will no longer be available in the InnoLet insulin pen device and would require those with poor eyesight and reduced manual dexterity to have others administer their insulin.
The editorial said that the reason for Mixtard 30’s decline in sales could be due to the fact that the insulin was not available in the FlexPen, which is available in Germany and is not being withdrawn from that market.
"The decision to remove Mixtard 30 will cause huge disruption and anxiety for people with diabetes, not least because it might take months to switch successfully to another form of insulin,” said Ike Iheanacho, MD, editor of DTB. "And at a time of tight budgetary constraint, the added costs inherent in this move are an unwelcome blow for the NHS."
DTB has set up an online petition to rally against the possible costs linked to Novo Nordisk’s decision.