Increasing preference of diabetolgists to prescribe only high priced insulin brands of MNCs is badly hitting business of domestic insulin makers. Although domestic players offer equally effective insulin products at 25 to 30 per cent cheaper than MNC brands, they are yet to make an impact in the market because of the prescribing practice of physicians. This trend is putting several diabetic patients also in a serious dilemma.

The mechanism of price approval by the National Pharmaceutical Price Authority (NPPA) does not seem to be correct and is lopsided in favour of MNCs. This has resulted in different prices for insulin products marketed in India by MNCs and Indian companies. There should be some kind of uniformity in pricing of insulin brands sold in the country, industry source said.

However, MNC firms counter this argument by stating that they are innovators' molecules and the higher price is insignificant considering the benefits they extend to patients. "The reliability and investment in cold chain by MNCs cannot be matched by Indian firms. No Indian company offers the service and education MNCs provide to the doctor and patient", said Dr Ammar Raza, pharmaceutical physician working for an MNC.

The insulin market in India is valued at Rs 300 crore and growing at 20 per cent annually. The three insulin MNC majors in the country: Novo Nordisk, Eli Lily and Aventis have captured 75 per cent market share. The remaining 25 per cent rests with Biocon, Wockhardt, Shreya, Ranbaxy and Dr Reddy's. Current estimates indicate that India has 40 million diabetics. With rising rates of obesity and the aging population, diabetes is an emerging epidemic and insulin dependence is increasing.

The pricing of Novo Nordisk range of Human Actrapid , Human Insulatard, Human Mixtard and Human mixtard 50/50 is Rs 158.68 for a vial. Eli Lily's Huminsulin versions R (regular), N (slow release) 30/70 (30 percent slow release and 70 per cent fast release) are priced Rs 158 each. But Indian manufacturers like Wockhardt 'Wosulin' and Biocon 'Insugen' are priced at Rs 122 and Rs 126 respectively. The difference in pricing of an MNC brand and Indian product ranges between Rs 32 and Rs 36.

VR Kannan, a leading pharma consultant, said that despite several appeals, NPPA has not cared to look into the issue of such huge price disparity between different brands of insulin. Because of this inaction, a large number of diabetic patients are being forced to pay a very high price for their insulin doses.