Acute insulin shortage in the country

Santo Domingo—For several months, there has been an acute shortage of insulin in the country’s private pharmaceutical sector, especially one of the most widely used, type 70/30.

The situation has forced patients to go to the Instituto de la Diabetes (INDEN) and the Farmacias del Pueblo in search of the product, which still has a supply but is registering a high increase in demand.

This shortage is generating serious difficulties for patients with diabetes who require the use of insulin as an indispensable treatment for the control of their condition and who acquire the drug in the private sector, especially those with type 1 diabetes, who are insulin-dependent, as well as concern among endocrinologists and diabetologists.

The drug is also used by about 40% of patients who have type 2 diabetes, which is estimated to occupy 90% of the people living with this condition in the country, where studies indicate that about two million people live with diabetes or more than 13% of the Dominican population is affected by this condition of increased blood sugar.

The shortage of medicine in the private market and the difficulties for the supply were confirmed to Listín Diario by the president of the Dominican Society of Endocrinology and Nutrition, Sherezade Hazbún; the executive director of the Union of Pharmacies, Scarlet Sánchez; the director of the National Institute of Diabetes and Nutrition (INDEN), Ammar Ibrahim and the executive director of the Program of Essential Medicines (PROMESE/CAL), Adolfo Pérez and Arelys Mercedes, president of the Dominican Society of Diabetology.

They assured that the shortage of the product affects the private sector but that this does not occur with the hospitals of the Public Network that have maintained their rhythm of use without alteration, nor the People’s Pharmacies or the Diabetes Institute, since they have a stop of the medicine in stock due to their large volume purchase and long-term agreements with their international suppliers.

ARAPF EXPLAINS CAUSES
Regarding the problem, the Association of Representatives, Agents and Pharmaceutical Producers, Inc. (ARAPF) explained that currently, the global production of drugs related to glycemic control for insulin-dependent diabetic patients faces significant challenges in planning due to the shortage of an essential component for the manufacture of insulin, as a result of the increase in the number of patients with diabetes.

“This situation has resulted in a worldwide shortage of the product, recently affecting the Dominican Republic. This decrease in availability has been manifested mainly in the vial presentation, as it is the one most commonly used by the population; however, in the pencil type presentation the supply has been stable and has not presented any affectation in a general way”, affirms the entity in declarations offered to Listín Diario.

It points out that the relevant institutions have the necessary availability to respond to the immediate needs, and the pharmaceutical laboratories “which we represent assure to have shipments on the way, with availability to guarantee the access of this to the patients.”

The organism understands that “this feeling of shortage” should not be prolonged and that this type of medicine will be supplied regularly in the next few days, so it should not represent a significant situation for the Dominican healthcare system.

Likewise, when confirming the supply difficulties, Sanchez said that the Pharmacy Union does not know the causes of the problems that the laboratories or the industrial sector have in supplying the insulin demand that the pharmacies have, but that for months, they have been observing that when they receive the order, especially the insulin 70/30 units, it is immediately sold out in the chain of pharmacies that they represent.

SIX-MONTH SUPPLY
The PROMESE director also assured that the medicine is guaranteed in the Farmacias del Público and that they have enough of the product in stock for the next six months due to the planning done and the purchase agreements signed with suppliers.

“Even if the private sector were to run out completely, we at PROMESE have enough to guarantee insulins to patients for the next few months,” he said, recalling that worldwide there are difficulties because Ukraine is one of the leading suppliers of insulin and biosimilars in the world. It has been affected by the war with Russia.

USE IN COMBINATION
Ibrahim explained that the most significant shortage is observed in the 70/30, which is a mixture of the NPH human insulin 70 units of rapid insulin and 30 units, so if a patient runs out, he can go to his doctor and ask him to explain that he can take 70 of one and 30 of the other because it can be combined since the mixture was made to avoid the patient having two punctures at the same time.

He said that INDEN still has a drug supply and that the manufacturers promise new deliveries before the end of this month. He assured us that they have been supplying a large part of the patients who go there in search of the drug.