Pharmaceuticals

The Lobbying for Death by Diabetes


• "These provisions increase the chance...any diabetic is diagnosed"

Diabetes is the fifth-highest killer in the U.S. after heart disease, cancer, stroke, and respiratory illnesses. More than 70,000 Americans die of it each year, according to the Centers for Disease Control & Prevention. Still, Novo Nordisk (NVO) says the ailment doesn't get the attention it deserves.

The Danish drug company, the world's largest maker of insulin, says that coroners and doctors underreport how many people die of the illness. To boost diabetes' stature, it used connections in Congress to get a provision into the health reform law that will have it listed far more often as a cause of death.

A higher death toll will mean more government and private funding for treatment, detection, and prevention of the disease, says Michael Mawby, Novo Nordisk's Washington lobbyist. It is also likely to spur higher spending on drugs.

That's not to say that the legislative change is just a marketing ploy. The new provisions will lead to a better understanding of diabetes among doctors, says Robert Anderson, chief of mortality statistics at the CDC. By not listing it as a cause of death, "They certainly underestimate the impact," he says.

Thanks to the reform bill, along with the growing prevalence of diabetes, the company's insulin sales in the U.S. could double to $4 billion in 2018, from just under $2 billion in 2008, predicts Dr. Donny Wong, a London-based pharmaceutical analyst with consultants Decision Resources. Industrywide, total U.S. sales of insulin and oral diabetes drugs could rise to $24 billion from $10.3 billion in 2008, he says.

In coming months, regulations will spell out how the new law will be applied. After that, when a patient dies from complications of diabetes such as a heart attack or stroke, coroners will be encouraged to record diabetes as well on the death certificate. That wasn't the case prior to the legislation.

Public health officials will consider the rising mortality data when they allocate research funds. The states also may be required to publish regular reports on how they are improving diabetes care, and medical schools could be asked to improve training in this area. "These provisions will increase the chance that any given diabetic is diagnosed," says Jack Scannell, an analyst with Sanford C. Bernstein (AB) in London.

Novo Nordisk says it went to Senator Kay Hagan, a North Carolina Democrat, with data showing that almost 10% of the people in her state had diabetes. "She got religion on this. She started looking at the numbers, and she was just great," says Mawby. Hagan says she was interested "because in North Carolina over 600,000 adults have diabetes." Her state also has a 400-employee Novo Nordisk factory in Clayton that manufactures and distributes insulin products, according to the company's Web site.

With Novo Nordisk's help, Hagan began signing up co-sponsors for a stand-alone diabetes bill she introduced in July 2009. It contained the provisions that eventually were included in the health-care overhaul. The company donated $2,000 to Hagan's campaign through its political action committee.

Novo Nordisk also lobbied Representative Zach Space, an Ohio Democrat who has a diabetic son and who has made diabetes treatment and prevention a signature issue. The company gave $2,820 to his campaign. Space's office did not return several messages seeking comment.

The bottom line: Novo Nordisk's lobbying during the health-care debate should result in better care for diabetics and fatter revenues for the company.

Armstrong is a reporter for Bloomberg News in New York.

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