The Drugs and Therapeutics Bulletin (DTB) has stepped up its campaign to persuade Novo Nordisk not to pull its insulin Mixtard 30 from pharmacy shelves in the UK with a protest letter sent to the Daily Telegraph.

In June this year Novo announced plans to discontinue sales of its veteran biphasic insulin product Mixtard 30, which first hit the market over a quarter of a century ago, from January 2011, in a move that sent shockwaves through the diabetes community.

It is estimated that around 90,000 patients in the UK will be affected by the drug’s withdrawal, and under the DTB’s campaign a group of leading scientists and academics have written to the newspaper in a bid to put further pressure on the drugmaker to rethink its “short-sighted” decision.

The letter, which the DTB says echoes the views of more than 1,000 people who have so far signed its petition in protest of the plans, notes: “We are alarmed by Novo Nordisk’s attitude to people with diabetes who rely on Mixtard 30 and we urge the company to reverse a decision that is not in the interests of patients, healthcare professionals or the NHS”.

Mixtard 30 is a biphasic human insulin recommended by the National Institute for Health and Clinical Excellence as an option for diabetes patients needing insulin, and the letter’s signatories argue that Novo’s decisios to remove the product will “adversely affect the wellbeing of many people with diabetes and add millions to NHS costs”.

Analogue forms of insulin are being touted as replacements for Mixtard 30, but those currently on the market are more expensive. Assuming that patients are switched onto the drugmaker’s own NovoMix 30, the higher prescribing costs as a result could top £9 million in England alone, the letter warns, and points out that this does not include for the extra resources needed for discussing other treatment options with patients. Not great news at a time of financial austerity and savings targets.

Dwindling sales

Defending its decision, the company said that over the last six years the use of Mixtard 30 in the UK and Ireland has been on a steady decline, and that resources could be put to better use by focusing on the development of the next generation of insulins instead.

But the DTB argues that the declining use of Mixtard 30 in the UK could be addressed by making it available via the FlexPen, the mode of administration of the better selling NovoMix 30, and it notes that, in Germany, the drug is available in this format and there do not appear to be any plans to withdraw it there.