annual worldwide sales).15 In addition, worldwide sales of insulin for Aventis exceeded $250 million during 2001, more than 10% of the total sales of the company.16 Thus, total worldwide insulin sales for the three largest manufacturers exceeded $3.3 billion in the last fiscal year.
Clinical and Economic Decisions About Insulin Therapy Business or economic considerations will not and should never be the sole or even the prime basis for decision-mak- ing in the selection of insulin therapy. On the other hand, cost should be one criterion in treatment design. Certainly, a theoretical relationship between cost and clinical efficacy constitutes one valid basis for the selection of treatment.
The current climate in the insulin market involves strong marketing and clinical advocacy in favor of newer prod- ucts. As discussed, there are possible specific advantages of these newer prod- ucts. However, clinicians should consid- er price differentials as well in their
selection of insulin products with their patients. Novel pharmacokinetic proper- ties of insulin analogs and the ease of use of injection devices may enhance patient acceptance of insulin therapy and reduce hypoglycemia.
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4Novo Nordisk Corporation: Frequently asked questions. http://www.novonordisk- us.com/view.asp?ID=1264
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16Aventis: Annual Report, 2001. Frankfurt, Germany
Steven B. Leichte , MD, FACP, FACE, is codirector of the Institute for Healthcare Leadership in Columbus, Ga., and a pro- fessor of medicine at Mercer University School of Medicine in Macon, Ga.
Volume 21, Number 1, 2003 • CLINICAL DIABETES