HEAL Committee Report
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THE COMMITTEE FOCUS
On 3 February and 29 April 2003 the House of Commons Standing Committee on Health heard from various witnesses about the availability of animal-sourced insulins versus recombinant human insulin. The witnesses represented the perspectives of affected individuals, the pharmaceutical industry and Health Canada. During the two sessions, Committee members were told quite clearly that animal-sourced insulins are essential to a certain proportion of diabetics and that their availability must be maintained.
Witnesses told the Committee members about individuals who were unable to adjust to the recombinant human insulin for controlling their diabetes. Endocrinologist testimony confirmed this concern and suggested that a small percentage of diabetic patients who have been on insulin derived from animals (specifically pig or cow) for an extended length of time may not be able to make the transition to the recombinant human form for a variety of physiological, immunological and undetermined reasons.
A. Inadequate Medical Education
The Committee members are very concerned about the apparently limited knowledge held by physicians about animal-sourced insulins. Witnesses suggested that medical schools do not routinely educate students about this area of diabetes control and that the Canadian Medical Association does not include the option of animal-sourced insulins for diabetes in its guidelines. Witnesses emphasized that the animal-sourced insulins must still be actively marketed since they are indispensable to some diabetics.
Groups representing affected diabetics are apprehensive that the animal products may be discontinued due to the proportionally small market as compared to the recombinant product. Health Canada reported that individuals can purchase bovine insulin from the United Kingdom through Health Canada’s Special Access Program. However other witnesses suggested that this process is somewhat complicated as well as expensive to the patient.
C.
Pharmaceutical Companies and Supply
The Committee members learned that although Nova Nordisk has discontinued its porcine insulin production, Eli Lilly intends to continue to provide porcine insulin in Canada. However, it has recently discontinued one of its animal-sourced products and is under no legal obligation to provide the animal products. The Committee members are pleased that while other pharmaceutical companies have stopped supplying animal-sourced insulins due to a diminishing market share, Eli Lilly has continued to honour its stated commitment to those individuals who require the animal product.
The continuing reduction in availability of animal insulin products is a major concern for Committee members. While encouraged that Health Canada is actively working with Eli Lilly and patient groups on this issue, they would like proactive measures taken in order to ensure that the animal-sourced products remain available to those patients who require them. The Committee members want greater certainty that such products will be available at a reasonable cost. They also want improved education for physicians who provide medical care to diabetics.