Trending Clinical Topic of the Week (March 2-8): Insulin
Rising drug costs, concerns about supplies, and a newly approved device resulted in this week's top trending clinical topic. Recently, two US Congressional committees began investigating the rising cost of prescription drugs, most notably insulin. For example, Humalog went from $21 a vial in 1996 to a current price of $275. As legislative solutions are being sought, other strategies are under investigation that may help patients with diabetes worldwide. A recent study suggested that switching patients with type 2 diabetes from insulin analogs to human insulin may result in significant cost savings without other significant harms.
Another sign of high insulin costs in the United States, over-the-counter (OTC) insulin is now sold more often at Walmart than at pharmacy chains. Walmart currently sells an estimated 18,000 vials of OTC insulin daily, most at a lower price than what pharmacy competitors offer. Americans are also crossing the Mexican border in order to buy insulin at a fraction of the US cost. Border issues are also an increasing concern globally, as the possibility of a "no-deal Brexit” has led diabetes specialists to call on the UK government to clarify its plans to ensure the availability of insulin and other medications. Although officials have continued to express confidence in uninterrupted supplies, various groups remain concerned about specific strategies.
Finally, some positive news: The US Food and Drug Administration has approved the first insulin pump that can be used with different components of diabetes management systems. Tandem Diabetes Care's interoperable t:slim X2 pump can communicate with compatible devices, including continuous glucose monitors, blood glucose meters, and automated insulin dosing systems. The hope is that this product will help improve glycemic control through greater individualization. Given the global rise in diabetes incidence, insulin is likely to remain a trending topic.
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Cite this: Ryan Syrek. Trending Clinical Topics for March 2019 - Medscape - Mar 29, 2019.