The price cut on the human insulin would not necessarily mean faster switchover from porcine or bovine insulin to human insulin, according to diabetologists. And the manufacturers of human insulin, especially Eli Lilly and Nova Nordisk may not gain from the same as well. Though the slashed prices have come as a boon to many diabetics in the country, these diabetics, currently on either porcine or bovine insulin, cannot immediately switch over to human insulin without the help of diabetologists.

According to Dr. V. Mohan, chairman and managing director, M.V. Diabetes Specialities Centre (P) Ltd, Chennai, the high level of purity notwithstanding the presence of one amino acid in case of porcine insulin which is not seen in humans cannot be wished away since the same produces a probability of antibody formation in some patients.

He further explained that increase in efficacy with human insulin may be seen in these patients and hence switching over from animal to human insulin should be done under medical supervision. “The thumb rule is to reduce the dosage by 15-20 per cent when changing over. But the chances of maintaining the dosage at reduced levels are slim. This is not the case with bovine insulin. The three amino acid difference between bovine and human insulin has a cascading effect on efficacy and antibody formation,” Dr. Mohan adds.

Many diabetologist aver that porcine insulin now produced has purity comparable to human insulin and there exist only a theoretical possibility of antibody formation in diabetics. “We don't find much of it in our patients,” Dr. Mohan confides, who further claims that the same exists for allergy too. “The price factor will play a role but I don't think it will happen all of a sudden. Prices of the human insulin has been brought on par with that of porcine and bovine insulin, but the switchover will not happen fast for the simple reason of the missing amino acids. In the longer run there may be a switchover which will benefit the companies,” another diabetologist, who did not want to be named, confided.

Another school of thought has it that the price of human insulin may not remain on par with the porcine or bovine insulin in the long run as exodus from the latter to the former may take place. The companies will only be able to reduce or keep the prices on par if they increase the manufacturing capacity of human insulin. “We will not be able to tell you whether the same will happen or not but the companies have a difficult task on hand,” a diabetologist maintained.

In contrast to the opinions of the diabetologists, industry source claim that there could be increased production of human insulin in the country and this could result in diabetologists preferring a switch over from porcine or bovine insulin to human insulin. Further they contend that diseases such as the mad cow disease finding its way to humans can be a reality when bovine insulin is used, with the same going in for porcine insulin. “Human insulin in that case would be the best bet,” the sources maintain. The further maintain that large production of human insulin in the country will help maintain prices at a lower level. However they failed to explain whether the increased production would be done before a switchover from porcine and bovine insulin to human insulin happens or after that. “There are 50: 50 chances,” claims a source.

However another school of thought within the industry claim that the companies Eli Lilly and Nova Nordisk have slashed the prices of human insulin not to benefit the diabetics but in anticipation of low prices of Indian companies which are getting ready to launch their own version of human insulin. Indian companies such as Wockhardt, Biocon India, Bal Pharma and Bharat Biotech have announced that they would be introducing their version of human insulin by this year end. “It is due to the announcements made by these Indian companies that the two foreign companies have slashed their prices. They could further lower or increase it depending on the price fixed by the Indian companies. Till then the slashing of the prices may just be taken as temporary, “ an industry source analysed, claiming further that switchover to human insulin may take some more time than what is expected by these companies. “Surely it will happen but not all of a sudden. They will have to wait for more time that they have fixed,” the industry source said.