Adult patients with diabetes have difficulty obtaining ultra-fast insulin aspart Fiasp

Adult patients with diabetes have encountered difficulties in obtaining ultra-fast insulin aspart Fiasp, after injection of which they can eat food almost immediately. In the first quarter, government purchases of the drug decreased by 95%, and it can no longer be found in pharmacies. Manufacturers explain the delays by increased demand. There is an analogue on the market from the Russian Geropharm, but its supply volume is still insignificant.

Government purchases of insulin aspart in January-March 2024 decreased year-on-year by 70%, to 350.7 million rubles, Headway Company calculated for Kommersant. At the same time, purchases of fast-acting insulin Fiasp from the Danish Novo Nordisk, which previously led in volume among drugs in this segment, immediately fell by 95%, to 22 million rubles. A year earlier, hospitals and regions purchased Fiasp for 442 million rubles, which amounted to 37.4% of all purchases of insulin aspart.

This product is also not available in retail: according to AptekaMos, it is not available in pharmacies in Moscow, the Moscow region, St. Petersburg and a number of other regions. The drug is not available in the assortment of large online sellers Apteka.ru, Sber Eatteka and others.

Novo Nordisk told Kommersant that it supplies insulin, but due to increased demand, there are delays in the supply of some drugs. They indicate that, trying to ensure the availability of drugs at distributors and pharmacy chains, they “give priority to preferential distribution.”

Fiasp is an ultra-short-acting insulin aspart used in patients with type 1 diabetes. It provides a fast absorption rate due to the addition of niacinamide. In Russia, the product is produced at the Novo Nordisk plant in the Kaluga region until the packaging stage, as follows from the regulatory certificate for the drug.

According to RNC Pharma, in January-February 2024, half as much Fiasp was supplied to the Russian Federation as a year earlier – 90 thousand versus 200 thousand packages, while in 2023 the volume of supplies increased by 23.4%, almost up to 1 million packages. In 2023, sales of the drug in pharmacies, according to RNC Pharma, decreased by 29%, to 12.58 thousand packages. In Russia, insulins are provided to patients with diabetes free of charge, but some of them prefer to buy specific insulins themselves in pharmacies.

President of the Moscow Diabetes Association Elvira Gustova confirms that problems with the purchase of the drug have been observed since the end of 2023, and already in 2024 some regions were unable to purchase Fiasp. According to Headway Company, in January-March 2024, 35% of announced auctions for the purchase of insulin aspart were canceled, a year ago – 25%.

Children do not have any particular problems with receiving Fiasp, explains Tatyana Frolova, an endocrinologist at the Be Healthy clinic. But, according to her, adults “even in many clinics in Moscow are not given the drug, not to mention in the regions.” In addition, the doctor points out, it is “becoming increasingly difficult” to purchase Fiasp in pharmacies on your own. As stated in Novo Nordisk’s response to a request from one of the public organizations, the next delivery of Fiasp is expected only in June of this year (Kommersant has seen a copy of it).

Fiasp, which is an ultra-fast insulin, is convenient because patients with diabetes can pause for about five minutes after the injection or neglect it altogether and immediately start eating, Ms. Frolova points out. With other ultra-short-acting insulins available in the regions (Apidra from the French Sanofi, Humalog from the American Eli Lilly), the effect, according to her, occurs a little later, and not all patients are ready to change their usual drug.

In October 2023, an analogue of Fiasp under the Rinfast Nick brand was registered by the Russian company Geropharm. In January-March 2024, the volume of its government purchases was small – 37.8 million rubles, according to Headway Company. The company says that production capacity allows it to meet patient demand for the drug, but “production volume planning takes into account existing demand.” Since the beginning of the year, the company, according to its data, has produced 300 thousand packages.

The Ministry of Health told Kommersant that the supply of insulin aspart in the country as a whole is 8.6 months, in clinics – 10.5 months, in pharmacies – 2.5 months. They added that manufacturers did not report any cessation of supplies.

Polina Gritsenko