Lilly’s Carelessness in Discontinuing 3 mL vials of Humalog Causes Shortages in 10 mL vials of Humalog + Unbranded Lispro by Scott Strumello for, 9 April 2024.

In mid-March 2024, the JDRF shared news about how Eli Lilly & Company, Inc. was reporting that 10 mL vials of Humalog and the company’s identical, unbranded (meaning Lilly sells it using the generic drug name rather than brand-name Humalog) version of Humalog known as Lilly Insulin Lispro Injection could be facing temporary lack of availability in selected locations around the country. Lilly tried to reassure everyone that it was only a temporary issue. But while Lilly complains it cannot keep up with demand for Mounjaro/Zepbound, it is having its own supply disruption for its blockbuster prandial insulin analogue.

However, several days later, we learned somewhat more about the reason for the Humalog 10 mL vial shortage from the U.S. Food and Drug Administration. Below is a link to the FDA’s “drug shortages” web page. Essentially, the reason for the April 2024 10 mL vial shortage of Humalog/unbranded Lilly Insulin Lispro was because on March 27, 2024, Lilly quietly decided to cease making and distributing smaller, 3 mL vials of Humalog. That meant that anyone who used Humalog 3 mL vials but went to the pharmacy for a refill were told they could only buy 10 mL vials instead. After all, people who used the smaller 3 mL vials can still buy the bigger 10 mL vials (only it will cost them considerably more money). 

On the surface, it’s not a huge deal. But it raises a legitimate question. Shouldn’t Lilly have been better prepared? ClinCalc and the government’s own annual Medical Expenditure Panel Survey (MEPS), a survey conducted by the Agency for Healthcare Research and Quality (AHRQ), do not even register a 3 mL vial of Humalog among the 200 best-selling drugs. It’s hardly surprising. That’s likely why Lilly decided to stop making the smaller-sized vial. But shouldn’t the company have ramped up production of the 10 mL vials before pulling the plug on the 3 mL vial? In my view, it means the company really did not consider the consequences of its decision.

We see something very similar going on right now with rival Novo Nordisk’s decision to stop making and selling the basal insulin analog known as Levemir. That company hopes Levemir users will switch to its newer basal insulin analogue branded as Tresiba.

What if one, two or all of the major branded insulin-makers might decide in the future that it is in the best interest of their shareholders to exit the highly-commoditized insulin business completely? That is a major concern because we know thanks to academic research that margins on insulin have continued to decline.

The reason insulin price-cuts are a non-issue is because those price reductions were completely bankrolled by disintermediating the rebate-aggregating Pharmacy Benefit Managers (PBMs) from insulin sales. Voila: 70% to 80% price cuts were accomplished with absolutely no impact to their bottom lines. It’s amazing when multi-million dollar legally-exempted rebate kickbacks are eliminated how much the manufacturers were able to cut insulin prices. And, it did not cost them a cent.  Nothing. Nada. Zilch. 

But what would happen if Lilly, Novo Nordisk or Sanofi (one, or more of them) decided to exit the commoditized insulin business?  That is a question that we need more diabetes organizations to address with contingency plans now.

Read more: Lilly’s Carelessness in Discontinuing 3 mL vials of Humalog Causes Shortages in 10 mL vials of Humalog + Unbranded Lispro

Type 1 Diabetes Moonshot is the largest global community of innovators and funders collaborating to prevent, manage, and cure Type 1 diabetes.  Learn about them here.

StartUp Health is on a mission to solve the biggest health challenges of our time by creating and sustaining a global ecosystem of Health Moonshot Communities.  Health Transformers through StartUp Health’s T1D Moonshot Fellowship participate in the world’s largest collaborative community of entrepreneurs and innovators coming together to solve the biggest health challenges of our time. Anchored by a program-related investment from The Helmsley Charitable Trust, the three-year fellowship is designed to help T1D innovators achieve their health moonshot.

When StartUp Health set out to form a Type 1 Diabetes Moonshot, our first step was to form a mission-aligned, cross-disciplinary impact board that brought together the brightest minds from the top organizations in T1D globally.

Mission control for the health moonshot, the T1D Moonshot Impact Board is thoughtfully composed of a diverse ensemble of philanthropists, foundations, academic institutions, industry leaders, pharmaceutical experts, families impacted by T1D, and enterprising entrepreneurs.

They use a “scorecard” to measure that partners and projects both align with their mission and are capable of delivering impact.  Some of the projects in process:

Read more: 

David Paton’s 1970s pop-rock band Pilot recorded two albums at London’s Abbey Road Studios. In his second life, as an in-demand studio and touring musician for the likes of Kate Bush and Elton John, he clocked numerous sessions with the prog-rock outfit the Alan Parsons Project, whose namesake produced Pilot’s signature hit, “Magic.” In February 2023, Paton, guitar case in hand, strode across the most famous pedestrian walkway in rock history and into London’s Abbey Road Studios, again.

“I was 22 when I wrote it.” Now he was 73, and unsure if he could still reach those high notes. But Paton took his place in front of the Abbey Road microphone and confidently sang that indelible hook, only with the word “magic” swapped out for something less ephemeral and more pharmaceutical: “Oh, oh, oh, Ozempic.”

As television viewers are all too aware, that altered chorus from “Magic” serves as the advertising jingle for the Type 2 diabetes medication Ozempic. Since the product arrived in 2018, the censored version of “Magic” — first rerecorded by work-for-hire musicians, and then re-rerecorded by Paton at Abbey Road — has taken its place alongside such classics of the form as Subway’s “Five Dollar Foot Long” and McDonald’s “I’m Lovin’ It” as marvels of marketing ingenuity.

“It’s an earworm all right,” said David Allan, a professor of marketing at Saint Joseph’s University and the author of “This Note’s for You,” a book about music and advertising. “You can’t get it out of your head.”

Read more: How Ozempic Turned a 1970s Hit Into an Inescapable Jingle

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