. I’m age 58, male, skinny, I have a hemoglobin A1c of of 6.2%, and I have been a mechanical engineer by the Air Force for 31 years. I’m interested on information about how people in other countries handle their diabete. I use the Optipen Pro, which is a pen made by Aventis, snd is not available on the US market. My question is why not?

Pens are more expensive in the US than in Europe and so the market forces in the US work to discourage pen use. This is slowly changing.

In Europe, where most systems are nationalized for health insurance, the prices are regulated in much stricter fashion and so socialized medicine has decided that pens are more convenient, the companies provide them significantly cheaper than they do syringes and insulin.

SB

[Editor’s comment: As several of our Diabetes Team members pointed out, there is nothing that forbids companies from seeking FDA approval for use of such devices in the USA, except that the utilization rate by patients and physicians is much lower than elsewhere in the world, and it’s proven to be an uphill battle thus far for the manufacturers to try to change the US perception of the suitability of pens for use in the management of diabetes. It’s not clear to me whether this perception is a general societal issue about the acceptability of pens vs. syringes (sort of like whether a nation “decides” to drive on the right side of the road or the left side) or whether it’s largely cost considerations in the minds of either consumers or insurance company payors, or whether some other specific diabetes factor (such as the acceptability to the medical community of multidose insulin programs) that has influenced the USA to “evolve” away from Europe in the relative acceptance of pen devices. Sounds like a great thesis for somebody to write (if somebody hasn’t already done so!).

WWQ]