Allies Voice: What is diabusiness to you?
I've heard the tern "diabusiness" used in many ways for many things. The term "diabusiness" was described to me as the business of diabetes. Considering the head count for people with diabetes in the US is well over 20 million - I anticipate a bountiful response to this question: what does "diabusiness" mean to you?
To understand "diabusiness" you must look at the business behind diabetes. Worth well over $10 billion, "diabusiness" is an industry for drugs, medical devices and other products and services involved in the care of more than 20 million Americans with diabetes. Both people with diabetes and those without have found a niche in the industry. Whether for better or worse - can you blame them?
Back in the early 1920s, after Fredrick Banting discovered insulin - he sold the patent to Eli Lilly for $1. Banting had hoped that by selling the patent to Eli Lilly it would make the life saving hormone widely available as soon as possible. Hundreds of thousands were imminently relieved from their critical glucose levels with a single injection. Bam! And so It began - the business of diabetes was born.
But wait! Where is the business if there is no competition? Within the next few years Germany and Denmark began commercial production of bovine insulin for the treatment of humans. The pioneering entrepreneurs behind the insulin production are known today as the corporations Sanofi-Aventis and Novo Nordisk, respectively.
It would behoove Michael Moore to take a peek at the evolution of insulin, including the (untimely death of Fredrick Banting and the calamity chronicles of human insulin. Believe me, Mr. Moore, the documentary would warrant a nomination for an Academy Award. You'd definitely ruffle feathers in the FDA with this expose`. The true life story is stranger than fiction.
Now for the universal tool in diabusiness: glucose testing! We all do it. We all need it. We all loathe it. The loathing (in my opinion) comes from the extortive prices of each test strip. Testing is gospel when it comes to diabetes management. Cute little jingles like test don't guess linger in the back of my mind (thanks dLife). People with diabetes are captive consumers. Choose a meter you want and you swallow the full costs of test strips. Allow your insurance company to choose a meter for you and they'll pickup (most of) the tab. To me this logic is bent. Why can a company choose the meter I must rely on day-in and day-out? That's like letting the DMV choose your spouse. Well, not exactly - but it's just as unintuitive!
The industry for glucose testing devices is crowded. More than 50 companies worldwide market monitors. Glucose testing has enticed companies such as Abbott, Bayer, LifeScan/Johnson & Johnson, and Roche; insulin pump companies like Medtronic/MiniMed, Disetronic, Omnipod and Animas and smaller device companies such as Home Diagnostics and Sontra Medical Inc. Check the earnings reports on any of the aforementioned companies and you'll see why they chose the business of diabetes.
So here are my closing thoughts and then I yield the floor to my esteemed readers.
The incidence of diabetes in the US is expected to double in the next ten years. The World Health Organization says over 300 million people worldwide will have diabetes by the year 2010. How could this NOT be an enticing business opportunity? Yes, my skin crawls as I muster those words. However I think of this challenge in terms of where we stand (sinking) in our oil crisis. Many of us are addicted to oil - our homes as well as our planes, trains and automobiles thrive on it. Yet how many of us own stock in companies like Exxon-Mobil, Shell or Chevron?
Oil is a profound necessary evil. Diabetes, until we see the day of a cure, is a juicy steak for those hungry for profit. I don't begrudge anyone a successful investment. I applaud those who can make lemonade with the lemons life has dealt. Again I reflect on the very question that got me here: what is "diabusiness" to you? Good, bad or ugly - what can we do to insure our safety in a cut-throat business?
Categories: profits,Money,diabusiness,Business,Investments,Diabetes
I was once doing some research in old journals from the 1920s and came across a series of adds aimed at diabetics. These ads admitted that insulin was enormously expensive, but urged diabetics to use more of it, since the more insulin they took the more energy they would have, and the more energy they had the longer they could work, which would ultimately make it easier for them to afford the insulin. Talk about having to shop at the company store! Little has changed since then, although the gadgets we have to buy to stay alive have gotten more elaborate. I also notice that JDRF has just turned down Dr. Faustman's latest funding request, so it is clear the door remains locked on any esape for us slaves from the diabusiness plantation.
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At least competition means customer choice, to some degree. A monopoly would be far more worrying.
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If you look at the way Lilly/Novo removed natural animal insulins--playing follow the leader, until all were gone--I think you would see that the insulin cartel IS monopolistic in everything but name. Remember when rDNA came on the market--with promises of cost effectiveness? Have you seen the price of your drug-of-choice decline? So much for freedom of choice.
As for patient-friendliness, it is worth noting that are (as yet unapproved) non-invasive, inexpensive continuous bG monitors. But since that would threaten the $4 BILLION dollar strip making business--we haven't seen them in the marketplace, have we? Patient PAIN only matters to the patient.
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Hey Melody, Brent, Tim, Nick, Kelly and all other readers of “Allies Voice”,
What if a true “threat” to these monopolistic companies existed? What if a corporation emerged to “regulate” the business of diabetes?
The companies this “heroic holding house” would target are companies that have repeatedly ignored the welfare of their captive customers. Extortive insulin, dangerous studies to “train” the doctors, unrealistic expectations of patient compliance… the list goes on. We can summarize the crime to “murders and executions”. In the business world the punishment should fit the crime: mergers and acquisitions.
People with diabetes need a protector – a guardian. When you’re dealing with a multi-billion dollar business with NO evidence of safety regulation for the people – the obvious answer exists in the security of democracy: power to the people upon which “diabusiness” prey.
The movement could be profound. The vindication to protect people from being enslaved to the business of diabetes will be worth the fear-factor levied upon these businesses.
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Good point, cjk75! The oligopoly of insulin is about to get a few more names / choices. Perhaps this will wet the whistles of consumers to start thinking about what they want (and don’t want) from their insulin of CHOICE.
Thanks for your insight!
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To parents, outsiders, newbies, and charities collecting money in our name—diabusiness may be portrayed as a lifesaver. However, with all diabusiness has brought us, patients are guaranteed no better, no longer, or no more normal a life than when I was diagnosed in 1956. In fact, life may now be MORE dangerous, unpredictable, complication-laden and painful; but to diabusiness, the important aspect is that it is more expensive and thus more profitable.
Diabetics are merely pawns for diabusiness—useful as long as we contribute to their profitability, but in the grand scheme of things, expendable. We do most of the work (patient-intensive management) and spend lots of money. When something goes wrong, we shoulder the blame. From problematic pumps, inaccurate meters, an occasional bottle of bad insulin to the metrics that define us—bad numbers, too little exercise, too much exercise, too much food. You know the routine. Sadly, if you find a routine you can ‘live with’, you may see a favored medicine removed from the marketplace as its patent expires, and a newer, more expensive product is substituted.
When your (pump) infusion set clogs, or when your monitor throws out an ERROR message and you consume yet another expensive strip—minor inconveniences add in seemingly insignificant ways to your cost of diabetes. But diabusiness recognizes these in more substantial ways. Consider the dollars YOU have wasted on bad strips, sets, etc. Multiply that by the number of users (17 million?) and see that diabusiness profits even when no benefits are provided. Have YOU taken a defective strip back to a pharmacy to reclaim the squandered dollar? Were you reimbursed; or did you have to prove that the strip—not the user—was defective?
Life was much simpler when choice of insulins included a peakless, basal insulin and predictable quick-acting insulins for boluses. Improvements? I can attest that disposable needles are a significant improvement over re-usable syringes that had to be regularly sterilized by the patient. I admit that bG strips provide a more accurate indication of blood sugar level than did TesTape (urine testing). But is the expense truly justified when the reading provides a moment-in-time indicator of bG level? That moment-in-time reading doesn’t tell you whether your bG is rising, or falling, or is even accurate to a degree that validates its use.
Have you considered a true emergency situation? Suppose your technology is gone—no pump, no monitor, no strips. Imagine you have only a bottle of insulin, a syringe, and a little food. Could you survive? For how long? Diabetes may have made you a victim; diabusiness has worked diligently to make you a slave.
STATS: Insulin ranks 8th on the list of drugs causing adverse events. Less than 1% of the U.S. population uses this drug. Only 1-2% of adverse events are actually reported to the FDA. Diabetics die at the rate of 600/day, or roughly 200,000 per year. Is diabusiness truly a savior?
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Brent,
I’m flabbergasted! Your comment diabetes has made you a victim – diabusiness has made you a slave could explain the unequivocal opportunity cost these “advances” have charged those of us living with diabetes.
Your comments always open my mind just a little more. Thank you for sharing!!
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There are so many diabetes websites which are actually nothing but servants of Diabusiness and its minions, the Medical Establishment, yet they pose as open forums for patients to express themselves. But in fact,they wind up just reinforcing the dominant ideology, which says that medicine is constantly making leaps and bounds in the treatment of diabetes, and if there are any problems which diabetics still experience, it is their own fault for not testing, injecting, pumping every waking minute, and obeying the good doctor who knows best. But from my point of view, as a patient since 1966, the only change in my treatment plan of any significance, which was even then rather old-fashioned, being based on the 1936 edition of Howard Root's "Manual of Diabetes," is that the management has become so intensive that it is greatly reduced my everyday quality of life compared to the days of one injection in the morning, one or two meaningless repetitions of the urine sugar test a day, and otherwise just forgetting about the disease entirely.
I would like to see patients start an aggressive, brutally honest political movement of their own in opposition to the dominant ideology, so we could expose the gross inadequacy of the available treatments, the glacially slow, unimaginative, and irrational pace of research, and the mindless medical blood sugar police. Perhaps we could call it the 'Diabetes Revolutionary Front.'
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Allie, Sanktpauli, et al--
I received the following e-mail from a concerned friend today. I've removed identifiers (for privacy) but thought you would appreciate the fact that others also see a need for war:
FDA reports new deaths with diabetes drug Byetta
http://ap.google.com/article/ALeqM5iVSltX5F62C8JTAUimO8fk7WhO7QD92KRVVO0
http://www.reuters.com/article/marketsNews/idUSN1846009520080818
http://www.medadnews.com/News/index.cfm?articleid=564648
Kill 'em with the insulin, kill 'em with the fake lizzard spit, kill 'em by refusing to keep on making beef and pork. These are the vilest bastards on the planet, yet we have no organized war against them. We are supposed to be concerned about terrorism--they include domestic terrorism in that, but they don't see this company as terroristic like BinLaden, et. al.
Oh, BTW--don't forget to kill 'em with the Prozac, the Zyprexa, the Cymbalta and the Xigris if the methods above don't work..........
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I wonder whence will coming our 'knight in shining armor'--perhaps a doctor or public health care advocate--willing to pit his/her intellectual/scientific knowledge against the status quo. How wonderful it would be for a leader to emerge, willing to challenge what has passed for 'science' lo these many years. Catchy advertising promotions and cherry-picked studies (that fail to reveal the near impossibility of patients' compliance) have worked only in the interest of diabusiness. The mere fact that quality of life has not improved (as well as other metrics) DESPITE the 'latest and greatest' from BigPharma should be a tip-off to an aggressive advocate that something is 'rotten'. Our collective voices obviously are not loud enough (yet) to overcome corporate dogma. But I hope eventually the house of cards upon which current medicine and treatment are based will come tumbling down. May those who place profits before patients (and we're talking about ALL of diabusiness, including doctors who merely regurgitate corporate PR, and charitable advocates who exploit our disease) be left wondering where all that 'sunshine' is coming from.
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I love Michael Moore's Documentaries. Sicko: A documentary comparing the highly profitable American health care industry to other nations and how they "invent" diseases to make their businesses more and more profitable.
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Good post.Today’s fast-acting insulins, anti-glycemic pills, and basal insulins, when combined as a protocol, leave the diabetic covering several peaks of insulin in each 24-hour period, some occurring during sleep time.
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