Diabetes is one of the most pervasive and costly diseases we have in America today.  In 2014, according to the Center for Disease Control and Prevention (CDC), 21 million people were diagnosed with diabetes, with another 8.1 million still yet to learn they have the disease.  That means roughly 9 percent of the population in America, knowingly or not, has diabetes. That’s five million more than the entire population of Australia!  

Since diabetes is so common and millions of dollars are being spent diagnosing and treating the disease ($245 million in 2013!), where are the great innovations? Where is, for instance, the long sought after oral insulin, which would alleviate diabetes sufferers from having to prick themselves with a needle every day?  The answer is complicated, and of course, involves money.

Any exploration on diabetes will find that research, while very promising, is still on the edges. Many of the big pharmaceutical companies have realized that the bar has risen and the next advancement has to be big in order for them to make money.  No longer can they put out a slightly incrementally better product and watch it fly off the shelves.  Dr. John Buse, director of the Diabetes Center at the University of North Carolina, more vividly details the problem, “It’s not like 10 years ago where you could market acarbose, a drug you have to take three times a day that makes you fart. Now that profile would never make it into Phase 2.”

A prime example of economics at work is the Danish company, Novo.  The company in October of last year ended research for the oral insulin tablet.  The research was killed because the company came to the conclusion that consumer wouldn’t pay more for the oral insulin.  The CEO of Novo explained the decision, “The payer environment … means that in mature areas, such as insulin, for instance, it is really a question of having a very high innovation threshold to justify new projects.”  Ultimately, the high cost of developing such a drug, coupled with the prospect of it not selling because a majority of diabetics would rather save money and stick with the needle led to it discontinuation.

Despite the uncertain horizon for advancements in diabetes medication, some doctors don’t see new drugs as the answer. Rather, we should be using what we already have.  For example, wearable technology, which needs no advancements, is available now.  Then there are the drugs on the market, not yet being used.  Why you ask?  Administrative paperwork is the answer according to Dr. Athena Philis-Tsimikas of the Scripps Whittier Diabetes Institute. There are “a ridiculous number of steps” for health care plans to cover the cost of new drugs. “It’s not like we’re desperate for something that is additionally innovative,” she said. “We’re not using what we have.”

Diabetes is a huge problem in the United States whether we want to admit it or not.  As with most problems, the answer doesn’t lie in some miracle drug that costs less than hard candy but in people.  Parents need to to take the time to educate their kids on the importance of diet and exercise.  Diabetes is a preventable disease, one that we are doing a terrible job managing.