ಮಾರುಕಟ್ಟೆಯಿಂದ ಮಾಯವಾದ ಪ್ರಾಣಿಜನ್ಯ ಇನ್ಸುಲಿನ್: ಕೇಂದ್ರ ಸಚಿವರಿಗೆ ಮನವಿ

ಮಾನವ ಇನ್ಸುಲಿನ್ ಎಂಬ ಮಹಾಮೋಸದ ಬಗ್ಗೆ ಈ ಹಿಂದೆ ಬರೆದಿದ್ದೆ.[ನೋಡಿ] ಮಾನವ ಇನ್ಸುಲಿನ್ ನ ಅರ್ಧ ಕ್ರಯಕ್ಕೆ ಲಭ್ಯವಿದ್ದ (ಕ್ರಮವಾಗಿ ರೂ. 150 ಹಾಗೂ ರೂ. 75) ಪ್ರಾಣಿಜನ್ಯ್ ಇನ್ಸುಲಿನ್ ಇದೀಗ ಮಾರುಕಟ್ಟೆಯಿಂದ ಮಾಯವಾಗಿದೆ. ಮಾನವ ಇನ್ಸುಲಿನಿಗೆ ನೀಡಲಾಗುತ್ತಿರುವ ಅಬ್ಬರದ ಪ್ರಚಾರದ ನಡುವೆ ಪ್ರಾಣಿಜನ್ಯ ಇನ್ಸುಲಿನಿಗೆ ಕುಂದಿದ ಬೇಡಿಕೆ, ಸರಿಯಾಗಿ ದೊರೆಯದ ಕಚ್ಛಾ ಪದಾರ್ಥಗಳು, ಕುಗ್ಗಿದ ಲಾಭಾಂಶ ಇತ್ಯಾದಿ ಕಾರಣಗಳಿಂದಾಗಿ ಪ್ರಾಣಿಜನ್ಯ ಇನ್ಸುಲಿನನ್ನು ಹಿಂಪಡೆದಿರುವ ಸಾಧ್ಯತೆಗಳಿವೆ. ಪ್ರಾಣಿಜನ್ಯ ಇನ್ಸುಲಿನ್ ತಯಾರಕರಿಂದ ಈ ಬಗ್ಗೆ ವಿವರಗಳನ್ನು ಪಡೆಯುವ ನಮ್ಮ ಯತ್ನಗಳು ಫಲ ನೀಡಿಲ್ಲ. ಹೇಗಿದ್ದರೂ, ಈ ನಿರ್ಧಾರದಿಂದ ಬಡ ಹಾಗೂ ಮಧ್ಯಮ ವರ್ಗಗಳ ಮಧುಮೇಹಿಗಳಿಗೆ ತೊಂದರೆಯಾಗುವುದರಲ್ಲಿ ಸಂದೇಹವಿಲ್ಲ.

ಪ್ರಾಣಿಜನ್ಯ ಇನ್ಸುಲಿನ್ ಪೂರೈಕೆಯನ್ನು ಖಾತರಿ ಪಡಿಸುವಂತೆ ಕೇಂದ್ರ ಸರಕಾರದ ಆರೋಗ್ಯ ಹಾಗೂ ಕುಟುಂಬ ಕಲ್ಯಾಣ ಸಚಿವರಿಗೆ ನಾವೊಂದು ಮನವಿಯನ್ನು ಸಲ್ಲಿಸಿದ್ದು, ಪ್ರತಿಯನ್ನು ಕೇಂದ್ರದ ರಾಸಾಯನಿಕ ಇಲಾಖೆಯ ಸಚಿವರಿಗೂ, ಔಷಧ ನಿಯಂತ್ರಣ ಮಹಾನಿರ್ದೇಶಕರಿಗೂ ಕಳುಹಿಸಲಾಗಿದೆ. ಆಸಕ್ತರು ಇಂತಹದೇ ಮನವಿಯನ್ನು ಕಳುಹಿಸಬಹುದು.
ವಿಳಾಸಗಳು ಇಂತಿವೆ:
Ministry of Health & Family Welfare
Nirman Bhavan,
Maulana Azad Road,
New Delhi – 110011,
Fax: 91-11-23062358

Ministry of Chemicals and Fertilizers,
Shastri Bhawan,
New Delhi , INDIA
Fax: 91-11-23383392

Central Drugs Standard Control Organization
Directorate General of Health Services
Ministry of Health and Family Welfare
Government of India, FDA Bhavan, ITO,
Kotla Road, New Delhi -110002
Fax: 91-11-23236973

Ensure Availability of Animal Insulin: Memorandum to the Hon’ble Minister of Health, Govt. of India

Dear Sir,
We are writing this to bring to your kind notice the fact that Bovine Insulin, the time tested drug that saved millions of diabetics over the past 85 years, has been withdrawn from the Indian market. Aggressive marketing of the so called ‘human insulin’ [with unsubstantiated claims of its benefits and denouncement of animal insulin], dwindling market share and lack of interest on the part of the medical fraternity as well as the pharma seem to have played a role in the disappearance of the animal insulin. Preparations of human insulin being almost twice as expensive as animal insulin (the average price of a vial of 400U of human insulin is Rs. 130-160, that of equal quantity of animal insulin is about Rs. 75 only), withdrawal of the animal insulin from the market will adversely affect the poor and middle class patients of diabetes who depend on this drug for long term treatment. We therefore place before you the following facts to impress upon you the need to ensure the availability of animal insulin.

It has been more than 25 years since the introduction of the synthetic insulin, named as Human Insulin. The claims of the manufacturers that 'Human Insulin' is more efficacious and less (or not) allergenic than animal insulin, that it has dose benefits and therefore would offset the higher costs and that with increased market share, there would be a reduction in its price have all so far remained unproven.

The Cochrane Review of 45 randomised controlled studies involving a total of 2156 participants concluded thus: ‘A comparison of the effects of human and animal insulin as well as of the adverse reaction profile did not show clinically relevant differences. Many patient-oriented outcomes like health-related quality of life or diabetes complications and mortality were never investigated in high-quality randomised clinical trials. The story of the introduction of human insulin might be repeated by contemporary launching campaigns to introduce pharmaceutical and technological innovations that are not backed up by sufficient proof of their advantages and safety.’[1]

Several adverse effects have been reported with human insulin, including allergies. Hypoglycemia and its unawareness are more common with human insulin and have even resulted in many cases of ‘Dead in bed syndrome’. Several experts from India and abroad support the view that evidence is lacking about the superiority of human insulin over animal insulin and that patients who do not tolerate human insulin should have the option of receiving animal insulin for treating their diabetes.[2-16]

It now appears that owing to pressures of the market, the suppliers of animal insulin have decided to withdraw it from the market and for the past few weeks, the supplies of animal insulin have been erratic and scarce. We therefore request you to take urgent steps to ensure the availability of all forms of animal insulin (regular, long acting and pre-mixed) in the Indian markets so as to help the poor as well as needy patients.

Thanking you, Yours sincerely,

Dr. B. Srinivas Kakkilaya, Consultant Physician, Light House Hill Road, Mangalore
Dr. Chakrapani, Professor of Medicine, Kasturba Medical College, Mangalore
Dr. Raghuveer, Assoc. Professor of Pediatrics, Kasturba Medical College, Mangalore
Dr. Ashok Bhat, Assoc. Professor of Nephrology, Kasturba Medical College, Mangalore
Dr. Shrikant Hegde, Consultant Physician, Shivamogga
Dr. Somanath, Consultant Physician, Bellary

References:

1. Richter B, Neises G. 'Human' insulin versus animal insulin in people with diabetes mellitus. The Cochrane Database of Systematic Reviews 2005, Issue 1. Available at
   http://www.cochrane.org/cochrane/revabstr/AB003816.htm
2. The GM 'Human' versus natural animal insulin debate. Available At
   http://www.iddtinternational.org/gmvsanimalinsulin/index.htm
3. Paul Brown. Diabetics not told of Insulin Risk. Guardian UK 9 Mar 99 Available At
   http://www.mindfully.org/GE/Diabetics-Not-Told.htm
4. Frank Lesser. 'Human' insulin loses its clean appeal. New Scientist. 15 April 1989. At
   http://www.newscientist.com/article/mg12216603.000-science-human-insulin-loses-its-clean-appeal-.html
5. Prasanna Kumar KM, Bhat GK. Animal Insulins - Current Status. Int J Diab Dev Ctries [serial online] 2003 [cited 2008 Apr 22];23:6-9. At
   http://www.ijddc.com/text.asp?2003/23/1/6/26806
6. Moses SGP. Bovine Porcine and Human Insulin. A present day comparative appraisal and policy discussions. At
   http://www.iddtindia.com/downloads/bovine_porcine.pdf
7. Moses SGP. Relook in to Insulin Therapy At
   http://www.iddtindia.com/downloads/relook.pdf
8. http://www.iddtindia.com/downloads/diabetes.pdf
9. Teuscher A. The Advantages Of Natural Insulin Diabetes Care At
   http://www.iddtindia.com/downloads/diabetes.pdf
10. http://www.iddtinternational.org/reviewsandreports/index.htm
11. The GM 'Human' versus natural animal insulin debate. At
    http://www.iddtinternational.org/gmvsanimalinsulin/index.htm
12. Bellagio Report 1996 - by the International Team Residency At
    http://iddtindia.com/bellagio.asp
13. Bhoraskar AS.Animal Insulin : Revisited - API Medicine update, Vol 12, Chapter 44, 2002 At
    http://iddtindia.com/aninsulin.asp
14. V. Mohan. Which insulin to use? Human or animal? Current Science 2002;83(12) At
    http://iddtindia.com/whichinsulin.asp
15. Kochupillai N, Goswami R. Natural Insulin is as Effective as Human Insulin: Recent Research Findings, API Update 2003 At
    http://iddtindia.com/ninsulin.asp
16. "Bovine Insulin as best treatment option" 18th Congress of the International Diabetes Federation - Paris, France, 24 - 29 August, 2003. At
    http://iddtindia.com/cidf_paris.asp