Weight-loss gold rush risks starving insulin supply, experts warn

The head of the Access to Medicine Foundation is sounding the alarm: the stampede into GLP-1 weight-loss drugs is dragging pharmaceutical companies' attention away from diabetes treatments, insulin included. In a new report, the Netherlands-based non-profit says the industry's gaze has shifted toward obesity since Novo Nordisk's Wegovy launched in 2021 and blockbusters like Ozempic and Eli Lilly's Mounjaro took off.

The stakes are enormous, the foundation says. Diabetes affects an estimated 589 million adults worldwide, and 81% of them live in low- and middle-income countries such as Pakistan, Egypt and Jordan. Many of those patients cannot get hold of basic insulin — the drug people with type 1 diabetes depend on — while many countries struggle to access GLP-1 medications at all.

That's partly a money story. Companies can charge far higher prices and bank fatter profit margins on weight-loss injections and pills than on older medicines like insulin, which leaves supply vulnerable if a major player walks away. "There is a risk that any of the three – Sanofi, [Eli] Lilly or Novo [Nordisk] – could leave the insulin market, and that will be disastrous for supply to insulin especially for people living with type 1 diabetes and insulin-dependent type 2 diabetes," said Jay Iyer, the foundation's chief executive. Novo Nordisk has already announced plans to phase out some older diabetes products, including insulin pens.

Even where GLP-1s are registered in poorer countries, the foundation says their high price and the absence of equitable pricing measures put them out of reach. Iyer pointed out that GLP-1 drugs are only just starting to enter those markets for obesity — and that the focus on obesity won't help people with type 1 diabetes, who after 105 years of insulin development still lack access.

The biennial report also found a development pipeline skewed toward type 2 diabetes: only 10 of 25 medicines in the works target type 1. On the ranking side, Switzerland's Novartis held the top spot in global health equity again after previously knocking the UK's GSK off it, while AstraZeneca climbed to third, with access plans for almost all of its late-stage drugs. Nearly two-thirds of cancer drugs now come with measures to make them available in poorer countries — and Iyer said two decades of the index show access has become part of corporate strategy at some firms, sometimes even written into executive bonus targets.