Ever heard of MedCo Health Solutions? It's not a household name like the big pharmaceutical companies Novo, Glaxo etc. However, MedCo, which happens to be in the prescription benefit management business, is a large and powerful company. Now it's about to become even larger: the company is poised to pay $1.5 billion for PolyMedica Corporation, the nation's biggest supplier of diabetes-related products.

According to a Forbes report on the deal, PolyMedica has nearly one million patients using its products. Its product line includes Liberty Healthcare brand, blood glucose test kits and meters, lancet kits, insulin and the like. The Forbes article says the move is basically a smart one on the part of MedCo: it can cash in on the growing demand(14.5 % growth, annually!) for diabetes supplies. MedCo's chief exec, David Snow, told Forbes he anticipates the purchase could make his company (indirectly) the supplier of diabetes treatment products to half of all insured Americans with diabetes.

Factoid: ads for PolyMedica star "Cocoon" and "Seinfeld" actor Wilford Brimley.

Drug War '07: drug giants Novo Nordisk and Sanofi-Aventis have been sparring recently over their insulin pen designs. Novo alleges Sanofi has stolen its design ideas, basically. Check out Bev's post on this to learn more.

The reason it's such a big deal to them is money. The insulin pen could be super-lucrative for investors. Meanwhile, here's some news that's bound to get big pharma even more excited: a new study reports that insulin pens are cheaper and more effective than insulin shots.

Why so good? Fewer trips to the emergency room and fewer visits to the doctor. Insulin pens boast a pre-measured dosing system, with each dose of insulin contained in a single, disposable cartridge. This eliminates the risk of over- or under-dosing, says senior author of the study, Dr. Rajesh Balkrishnan of Ohio State University in Columbus. The researchers say that study participants who used an insulin pen instead of a regular syringe ended up reducing their annual healthcare costs by nearly $17,000. Wow.

What I'm not clear on here is whether or not they factored in the added expense of upgrading from syringes to insulin pens.

Want to know more? The study has been published in the latest issue of Clinical Therapeutics, but you can click here to read a summary.

For those diabetics injecting insulin and getting frustrating results - this blog's you. I include in this group of frustrating results: hypo unawareness, diabulemia, lethargy, weight gain, erratic blood sugars, and missed periods (for the ladies) - these are all side effects people have experienced once beginning genetically modified human insulin. It so happens it is the only kind available in the United States.

Bev did a terrific blog on the Insulin Dependent Diabetes Trust and the difference a choice has offered me: more controlled blood sugars, lower blood pressure, less hunger and even a little weight loss - high five! But herein lies the problem - the choice is not easy to come by. Most doctors believe Big Pharma pushed genetically modified human synthetic insulins because it was better. However this, like the insulin analogues - was nothing but stellar marketing with lackluster scientific proof.

If any of those symptoms listed in my first paragraph kept you reading to this point - please ask your doctor to give natural animal insulins a second chance. Do yourself and other diabetics a favor and request information to bring to your doctor by emailing enquiries@iddtinternational.org. The IDDT will send information on natural animal insulins. You may not be interested, but another diabetic may love the fact it will soon be a choice for them. Freedom of choice - isn't the Liberty Bell appropriate here?

The CafePharma message boards are for pharmaceutical sales professionals and those interested in the pharmaceutical industry. A former Lilly sales rep started a thread about Eli Lilly and the lies they've told over the years. Pro Lilly responses flooded in, as did the anti-Lilly responses. Yesterday, however, two comments seemed to hit the message board with a vengeance.

Comments #23 and #24 epitomize the anatomy of a good old fashioned debate. Comment #23 is an Eli Lilly sales rep who claims to have helped with the successful launch of rDNA insulin, and the conversion of patients on pig and cow insulin to Humulin. He remarked from the perspective of a salesman that it was a successful venture resulting in unilateral domination. In response to his yesteryear achievement - commenter #24 raised some wonderful counter-points for modern day consideration. The following paragraph summarizes the results 25 years after the market saturation of Humulin and genetically modified human insulin.

The adverse events include: (1) Complications of diabetes are increasing. (2) Dead-in-bed syndrome is up over 300%. (3) Traffic accidents caused by people using rDNA insulins are increasing (especially in Type 2). (4) rDNA insulins are producing immunogenic responses in the same manner and numbers in the diabetic population as did pig and cow insulins. (5) No long-term studies have ever been conducted to define the dangers of the synthetic insulin hormones relative to cancer and other diseases.

Of course my favorite point is the fact that recent studies have shown that the culprit in many Type 1 diabetics may actually be the human insulin antibody produced by the diabetic. This may be self-serving beyond Type 1 diabetics needing insulin - it's giving Type 2s the very same problem.

In light of Novo's Meet the Face of Change campaign, I figured I'd address an idea worthy of mention coming out of the Novo product pipeline. This treatment is for Type 2 diabetics but it is not insulin - it's called liraglutide. Liraglutide is a once-daily human analog of the natural hormone Glucagon-Like Peptide-1 (GLP-1). It causes neither excessive hypoglycemia nor weight gain.

Liraglutide works by stimulating the release of insulin only when glucose levels become too high. Unlike many other diabetes drugs - liraglutide also leads to weight loss instead of weight gain. Now we're getting somewhere, Novo!! Patients with Type 2 diabetes treated with liraglutide had a greater reduction in average blood sugar than those patients treated with placebo or insulin glargine (Lantus). As expected, the combination of a GLP-1 analog with a sulfonylurea caused some of the patients to experience hypoglycemia. Okay, point taken. So why impose a glucose lowering drug while mitigating the problem causing elevated sugar in the first place? One drug at a time, folks.

So this is a step in the right direction and I like where it is going. Treating Type 2 diabetes with insulin is counter-intuitive. Looking at another hormone that might interfere with the use of insulin might be the culprit. So here lies a very good idea and I like it. Gold star, Novo! Now when can we meet the face of liraglutide?

I was excited to see my friend, Lissa Coffey, appearing on The Today Show this morning. Lissa is a PhD, a relationship expert and sociologist. Lissa shares her ancient wisdom and modern style through her site, Coffey Talk, and her newsletters. A recent newsletter addressed homeopathic medicine and I share with you how this applies to the treatment of diabetes.

Homeopathic medicine is a natural pharmaceutical science developed in the early 1800s. It uses small doses of natural substances (animal, vegetable, and mineral) to stimulate the body's own defenses. Homeopathy is a word derived from the Greek words for similar and disease. It is medicine based on the law of similars that says a substance will help to heal symptoms similar to those that it is known to cause. This is the same principle behind immunization.

When I received Lissa's newsletter on homeopathic medicine immediately I thought of how this applies to diabetes - a disease of insulin antibodies attacking the naturally produced insulin in the body. Why would you treat a disease with the exact hormone that caused it? Novo, Lilly, Aventis - you are all making a grave mistake in forcing American's to use GM human insulin, both Type 1 and Type 2. The extinction of porcine and bovine insulin has consequently proven to be detrimental to diabetics over the last 25 years. Studies show tighter control - yet complications on the rise. How do you explain this? I'm not excited for what the future holds, unless we see a return of these similar but not exact insulin forms.

For more the more than 300,000 users that once relied on animal-derived insulin, the final chapter of animal insulin is finally ending for the US market. In December 2007, Novo Nordisk has officially decided to discontinue making animal-insulin. Their explanation doesn't go into great detail why they chose to discontinue it. But the supporting evidence they use to warrant the decision is a little weak.

Novo says, animal insulin is derived from the pancreas of slaughtered animals. This statement is as true as the statement "human insulin is derived from the pancreas of slaughtered humans". Novo continues, since that time there has been significant improvement of insulin quality and formulation. Absolutely true! In fact, a Novo pork product was shown to be greater than 99% pure, while an Eli Lilly human insulin only exceeded the 97 percentile. As a consequence, demand for these old animal insulins has declined by as much 20% in the last year to a point where approximately 2% of all insulin users are currently using these products. Largely due to the fact doctor's were advising their patients they must prepare to switch to GM insulin because animal-derived insulin would be nearly impossible to obtain. True. The research that introduced GM insulin (back in the 80s) was preemptive, at best. The claims supporting it was better than the existing insulin choices was clearly debatable .A telling similarity to the discovery about Avandia.

The long-term results of GM insulin and its analogs would prove to be a nightmare if the right questions were asked, and the data properly collected. Is it fair for any of the companies to ask us to change from an insulin product we have grown to love? No, but much like the off-Broadway play suggests: We love you (as a customer). Your diabetes is perfect (for our bottom line). Now change your insulin (we don't feel like making that kind anymore). Too bad type 1 diabetics forced to change to GM insulin didn't have the outspoken advocates like those taking Avandia.