Improving access to diabetes care in the developing world is not simply a matter of medicines. Affordability of essential drugs is certainly an important part of the solution. Novo Nordisk has for decades offered insulin products at substantially reduced prices to countries in the developing world, and our best possible pricing scheme for the 49 Least Developed Countries is a continuation of this tradition.

Reaching out - Access to benefits - Best possible pricing to Least Developed Countries

Since 2001, we have offered our insulin products to the public health systems in the 49 Least Developed Countries (LDCs) , as defined by the United Nations, at prices not to exceed 20% of the average price in the industrialised countries of North America, Europe and Japan. This allows us to maintain overall profitability while still achieving the goal of more affordable pricing. The majority of the LDCs in Africa have been receiving animal insulin at or below the reduced price. Recently, the conversion to human insulin has been encouraged and letters have been sent to all affected countries explaining that human insulin in vials will be made available to them at the LDC price.

In 2003, 16 of the LDCs chose to buy insulin under the best possible pricing scheme. The volume of insulin purchased by these countries does not reflect actual needs, but is mostly dependent on financial and budget constraints.

Novo Nordisk operates in 30 of the LDCs. In all but one of them (Bangladesh) Novo Nordisk does not have its own affiliate in the country but operates through a local distributor. We will of course offer affordable pricing to any LDC country that chooses to purchase insulin products from us.

However, we have found that people with diabetes in these countries are often unlikely to benefit directly from reduced prices. While our products may be supplied to the distributor at the LDC price, this price is routinely marked up by governments, through import duties and domestic taxes, or by wholesalers and hospitals for additional profit. One exception is Senegal, where the state prohibits the marking up of insulin prices so that the benefit of reduced pricing can be passed directly on to the patient.

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Initiating a best possible pricing scheme for the developing world presents a dilemma. We want to see patients benefit directly from the lower prices, but pharmaceutical companies have limited influence over the way in which the prices of their products are marked up along the distribution chain. We will continue to work with patient organisations, governments, wholesalers and hospitals to encourage them to eliminate or reduce mark-up or taxes.

We also encourage the establishment of state tender systems in these countries, whereby a bid is submitted in response to a request for tender from the government. This may help to discourage price mark-ups in the distribution chain.

Best possible pricing to Least Developed Countries
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