In one way or another, this story affects over a million Ukrainians. It sounds banal, but it nevertheless true that Ukrainian diabetics are hostage to a conflict that has dragged on for five years. It dies down only to flare up again and again. Strange as it may sound, everything began when Ukraine set up its own production of insulin. The International Diabetes Association of Ukraine (IDAU) immediately criticized the quality of insulin manufactured by the Ukrainian plant Indar. According to IDAU director Liudmyla Petrenko, after switching to Ukrainian-made hormones people started to complain about deteriorating health and failing eyesight. There were reports of a rising incidence of gangrene. At the same time, she says, nothing could be done to improve this situation. “Diabetes” is the name of a government program that provides free insulin to diabetics. Accordingly, the Health Ministry buys insulin from a preferred manufacturer. In a matter of years, 70% of insulin-dependent individuals were switched to the product of the Indar plant, whereas most diabetics can’t afford to pay for the tried-and-true Novo Nordisk (Denmark) or Elli Lilly (US) insulin.
The conflict recently resurfaced. This time, however, the Indar plant management is pleading with the public to finally put an end to this insulin war. According to Indar director Oleksiy Lazarev, IDAU director Liudmyla Petrenko sent a letter to the new health minister, in which she accuses the Ukrainian insulin manufacturer of dishonest practices. She alleges, in part, that besides the quality of the product, which leaves much to be desired, the plant’s registration documents are forged. For its part, Indar has many grievances against the Health Ministry. According to Lazarev, the ministry is artificially creating an “insulin famine” in the country while smothering a unique plant, which is the world’s fourth largest insulin-producing facility with a full technological cycle.
Since 2004 the Health Ministry has been reducing its purchases of Ukrainian insulin, replacing it with the more expensive Danish product. This year, Lazarev says, it was toying with the idea of stopping purchases of the Ukrainian drug altogether. Meanwhile, the ministry can save up to 20 million hryvnias only by supplying 80% of the demand with Ukrainian insulin. Lazarev would like the government to understand one more thing. Working at 15% capacity, the plant produces 12 million insulin vials annually. “Under favorable conditions we would be able to capture a large part of the world’s insulin market, which is estimated at $4.5 billion,” Lazarev says.
No progress is visible, however. Indar employees are outraged at the constant complaints about the quality of their products. They refute them with an impressive list of arguments: Indar started producing insulin doses under license from the reputable German company Hoechst; plant workers undergo regular training in Germany; the quality control department has twice as many employees as the production department. Finally, the Pharmacy Examining Board, which records the side effects of every drug on the market once every five years, has cleared Indar’s insulin. This list can be continued.
Lazarev has an explanation for the situation in the insulin market. First, competitors see Indar’s potential and resort to unfair competition tactics. Second, there is a scheme aimed at the cheap privatization of the plant, 70% of which is in state ownership, by forcing it into bankruptcy. “The most horrible thing is that while these battles are raging, people are dying in the regions,” Lazarev says. According to him, after waiting in vain for centrally purchased insulin, desperate chiefs of some regional health care departments try to contact Indar directly. After all, Indar warehouses are packed full.
This situation is quite strange, to say the least. Neither Health Ministry officials nor, so to speak, public endocrinologists have ever questioned the quality of Ukrainian insulin. On the contrary, they oppose the IDAU, which demanded insulin imports not only for children and expectant mothers, but for most insulin-dependent individuals. Meanwhile, rank- and-file endocrinologists support the protesting diabetics. Off the record they recall numerous cases in their practice, when patients’ health deteriorated after injections of Ukrainian-made insulin hormones.
As for the “insulin famine,” it is news to the Health Ministry. As we know, Health Minister Mykola Polishchuk has suspended all government tenders, except for insulin. In a recent tender, the ministry selected the Farmak plant, which does not have a full insulin production cycle, and Indar, and purchased 500 million hryvnias’ worth of insulin from each company. Moreover, as The Day learned from the Health Minister’s press secretary, Uliana Lozan, there are no grounds to speak of insulin shortages today. According to Health Ministry statistics supplied by regional health care departments, the overall reserves of Ukrainian and imported insulin amount to 625,866 vials and 356,863 cartridges, or 20% of the yearly demand. Some regions have larger reserves and others, smaller. But in any case, there are technical means for a quick redistribution of insulin surpluses throughout the regions. A regional endocrinologist only has to write out an order to receive the required amount of drugs a day or two later.
In a word, there are no reasons to speak of any biased treatment of Ukrainian producers, let alone an insulin famine. Obviously, the current situation is only a sequel in a serial that diabetics themselves have dubbed “insuliniada.”
