Thread by @BullsforBears

Diabetes : Insulin market

Types of Diabetes Mellitus(DM)
1) Insulin dependent
2) Noninsulin dependent

Random blood sugar > 200mg/dl - DM

Fasting blood sugar
<100 normal
100-125 Prediabetes
>125 Diabetes (on 2 separate tests)

Post prandial
<140mg/dl normal
140-199mg/dl prediabetic
>200mg/dl after 2 hours Diabetes

Estimated 72.96 mn diabetics in India
Urban prevalence 10.9 to 14.2%
Rural 3 to 7.8%
Nearly 98 million people in India will have Diabetes by 2030
Highest prevalence, China 116 mn

Treatment of diabetes
Diet,exercise,insulin,oral hypoglycemics

Types of Insulin
1) Rapid acting - Humalog,Novolog
2) Regular(short acting) - Humulin R,Novolin R
3) Intermediate - Humulin N Novolin N
4)Long acting - Levemir,lantus
5)ultra long acting - Taujeo

Novo Nordisk is the worlds largest producer of Insulin, tie up with Torrent pharma since 1992 for manufacturing & distribution In India at its Indrad plant,produce about 34 million vials

Envision intelligence estimates prevalence of Diabetes growing CAGR of 7.4%

Annual sales of Insulin growing at 12% from 2012,estimated to reach $45bn by 2024

Top players
1)Novo Nordisk Denmark
2)Sanofi S.A France
3)Eli Lilly USA
4) Bioton Poland
5)Wockhardt India
6) Julphar UAE

Novo,Sanofi, Eli lilly control 90% of the global insulin market

Why is Insulin expensive
3 companies control 90% market,no generic were available until recently ,pay for delay schemes ,long expiry of patents( Sanofi filed 74 patents around Lantus,monopoly for 37 years),Politics, Price control

India's top 10 selling drugs in 2019 were dominated by diabetic products, MNCs
1)Mixtard Insulin Novo
2) Lantus Insulin Sanofi
3)Glycomet(Metformin) - USV
4)Galvus Met (Vildagliptin) Novartis
5)Janumet (sitagliptin/metformin) Merck
6)Augmentin GSK
7)Liv 52 Himalaya

8)Duphaston (Dyhydrogesterone) Abbott
9) Clavam Alkem
10) Thyronorm (thiamazole) Abbott

Average monthly expense for Insulin In india 3000 to 8000
Analogues ( newer versions of Insulin) priced 3 to 5 times the older versions
Human insulin $5.56 for 10ml
Analogues $19.05 for 10ml

Cost of Mixtard ( Nordisk) - 1 vial of 10 ml - 129
Lantus(sanofi) - 100IU (10ml) 400

In January 2020,Biocon said it will cut the price of Insulin to 7/day from 14/day for the average daily requirement of 40 units in collaboration with WHO,USAID to make it available to poor class

Jun2020 Biocon received approval from USFDA for Biosimilar insulin Glargine codeveloped with Mylan,only 1 biosimilar available at present $2.2bn market

March 2020 USFDA transitioned insulin to a new regulatory pathway,opening door for more biosimilar version of insulin & HGH

In Jan2020 the 3 big players authorized half price generics to be made available in the USA
Novo Nordisk - Insulin aspart & aspart mix,generics for Novolog & Novolog Mix
Eli lilly - Insulin Lispro,generic for Humalog
Also sanofi,though it expanded a help program as well

Diabetes reusable pen market is likely to reach $3 billion by 2022
China will account for 50% reusable pen market by 2022
Major players in reusable pen market
Novo Nordisk
Sanofi
Eli lilly
Owen Mumford
Vpsomed
Biocon

Diabetes & Insulin

@Coolfundoo @AnyBodyCanFly @koppik @unseenvalue @joshikshitij99 @thescorpionphil @AdityaKhemka5 @varinder_bansal @darshanvmehta1 @ms89_meet @punitbansal14 @kiranshaw @Bioconlimited @sanofi @WFIndia
#diabetes #bloodsugar

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