Novo Nordisk's decision to halt the sale of its long-acting insulin Levemir in the United States has left many diabetes patients in a dozen US states struggling to find alternative treatments, according to patients and doctors who spoke with Reuters. The Danish pharmaceutical company announced in November that it would cease US sales of Levemir by the end of 2024. Novo Nordisk explained that since the drug lost its patent in 2019, many health plans have stopped covering it, and there are other insulin options available on the market.
Several individuals with type 1 diabetes and parents of pediatric patients revealed to Reuters that they are hoarding the remaining Levemir supplies and using vials past their expiration dates, while also hoping that a new lobbying effort will keep the drug available. They argue that Levemir is particularly well-suited for young people and those with active lifestyles, as it allows for more frequent dose adjustments compared to other long-acting insulins.
Some patients have reported experiencing dangerously low blood sugar levels, known as hypoglycemia, or rapid fluctuations when using other long-acting insulins that Novo Nordisk claims are safe alternatives, including Tresiba and products from Eli Lilly and Sanofi. Jaime Losinki, whose teenage son was diagnosed with type 1 diabetes seven years ago and initially prescribed Sanofi's Lantus, said the problem of sudden low blood glucose episodes ceased when they switched to Levemir.
Novo Nordisk's decision to discontinue Levemir comes as the company increases production of its rapidly selling weight-loss treatments. The market value of the company has surged by $380 billion since the launch of its anti-obesity injection Wegovy three years ago, reaching $572 billion. In an emailed statement to Reuters, a Novo Nordisk spokesperson cited global manufacturing constraints and reduced insurance coverage as reasons for the discontinuation of Levemir in the United States.
Diabetes patient advocates are concerned that Novo Nordisk might be reducing production of less profitable insulins to meet the high demand for Wegovy, a claim the company denies. Dr. Kasia Lipska, an endocrinologist and professor at Yale University's School of Medicine, expressed her and her patients' anxiety about being at the mercy of pharmaceutical companies' decisions on resource allocation.
Advocacy groups estimate that over one million people in the United States were using Levemir in 2021, though it's unclear how many have since switched due to reduced insurance access. Novo Nordisk reported US Levemir sales of 1.3 billion Danish crowns ($185 million) in 2023, a significant drop from its sales in 2016 when the higher-priced Tresiba was introduced as a successor product.
While some diabetes patients can transition relatively easily between insulin regimens, others are highly sensitive to any changes, according to Lipska. Laura Marston, co-founder of The Insulin Initiative, noted that none of the alternatives cited by Novo Nordisk are exactly interchangeable, posing a risk for diabetics. The Insulin Initiative is primarily focused on lobbying for affordable insulin prices.
A new group of parents and patients, the Alliance to Protect Insulin Choice, has taken their concerns about Levemir to Capitol Hill. Their petition urging Novo Nordisk to continue manufacturing Levemir has collected over 4,000 signatures. Three Democratic US Senators have called on Novo Nordisk to continue producing Levemir until a cheaper, biosimilar version is available, according to a letter sent to the company in April.
The lawmakers are also urging Novo Nordisk to expedite the introduction of a close alternative to the market, either by facilitating the introduction of a biosimilar product or by making its patents available. Senate aides recently met with Novo Nordisk representatives to discuss Levemir. A spokesperson for the company stated that since Levemir has been off patent for several years, another manufacturer could potentially produce the drug if they choose to.
One father, Kirill Zenchenko from Massachusetts, shared that his seven-year-old son switched to Levemir after developing anxiety about using an insulin pump. Zenchenko is among those stockpiling Levemir, hoping to delay a potentially difficult transition for his son back to the pump or to Lantus.
