Earlier this week, Novo Nordisk released results of a sweeping new survey about how patients — both type 1 and type 2 — struggle with insulin therapy, and what doctors accredit that to.
Entitled the Global Attitudes of Patients and Physicians in Insulin Therapy (GAPPTM), the survey was conducted among almost 3,000 physicians and patients in eight countries "with the objective to learn what they perceive to be the biggest functional and emotional unfulfilled needs and challenges in the management of diabetes today, specifically relating to insulin treatment."
- More than one in three diabetes patients skip doses or fail to take their insulin as prescribed, stating that they have done so on average three times in the last month, and 77% of physicians estimate that in reality this number could be as high as six doses.
- 88% of physicians report that there are a significant proportion of patients still not reaching blood glucose targets, and four in 10 people with diabetes say they struggle to effectively control their blood sugar. Being too busy or simply forgetting to take the insulin are the main reasons cited by both patients and physicians for patients missing insulin doses.
- 67% of patients taking insulin are concerned about experiencing a hypoglycemic event in the future and physicians share patients' concerns, with 74% stating that they would treat closer to recommended targets if it weren't for fear of major hypoglycemic events.
- Nine in 10 patients wish there was an insulin that could be dosed less than once a day and effectively manage blood sugar.
The company's executive summary of results reads this way:
- Busy lives make it hard to comply with prescribed regimens
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- Fear of hypoglycemia may contribute to poor control
- People with diabetes are looking for less invasive insulin options
Like I said, no-brainer. Because yes, diabetes patients are real people, and real people aren't perfect. We have busy lives and sometimes forget things, even important things — although those of us with type 1 quickly learn the hard way what happens when you forget to take your insulin (hello, ER!)
Naturally, we worry about hypoglycemia. Lows not only suck, but they're scary and can be very dangerous. And obviously we'd like to dose less often and more conveniently. D'oh!
The press release includes a quote from Professor Luigi Meneghini, associate director at the Diabetes Research Institute in Florida, who says: "These results are consistent across countries and it is encouraging to see that physicians understand and empathize with the issues people with diabetes face."
Really? I wonder, has it been your experience that doctors understand and empathize with how hard it is to live on insulin? Most of the patients I hear from wish their doctors could walk just one single day in their shoes.
In any case, this survey is a clever move by Novo Nordisk. Not only is it great market research, but it allows them to position themselves as extremely "patient centered" while at the same time blaming any shortcomings of insulin therapy on us users. Notice how the headline says "Patients Fail..." Sure, the drugs are perfect; we aren't.
Maybe all of this praise for doctors is fuel for the new physician-targeted dosing product Novo has just introduced. NovoDose is a "mobile dosing guide" for physicians to look up insulin guidelines that's available in the form of an iPhone app. Wow, at least it's mobile, so that's pretty forward-thinking.
Did you hear about how Novo Nordisk actually pulled insulin off the market in Greece recently in a wrangle over government price cuts? Yikes! This is people's survival we're talking about here.
I heard an NPR story about this on my car radio two days ago in which a young type 1 woman effected was being interviewed. Her voice sounded so desperate, it gave me chills. There are surely lots of others out there who skimp on insulin because they can't get access to it, and/or can't afford it. (Makes me so appreciative of what I have)
The NPR story ended with the statement that Novo was considering making a "more affordable, generic version of the product" available in Europe soon. This made me want to scream! For how long have we been clamoring for such an option here in the US?
Yet according to this ADA article from 2007, Novo Nordisk (along with Eli Lilly) has actively pushed back on FDA action on approval of generic insulin. Grrrrr. (See Scott Strumello's update on Medco's positive efforts here.)
So while appreciate that the GAPP study sheds light on some day-to-day challenges we insulin-dependent people face, I'd really like to see Novo use their muscle in ways that might be even more beneficial to patients.
After all, according to leading analysts, "Novo Nordisk is one of the most successful pharma companies on the planet." If they can't help patients be less likely to "fail," then who can?