Key facts
- The Access to Medicine Foundation said Sanofi, Eli Lilly or Novo Nordisk could leave the insulin market, which it said would be disastrous for supply.
- The foundation's report found only 10 of 25 medications in development target type 1 diabetes.
- Novo Nordisk has announced plans to phase out some older diabetes products, including insulin pens.
- The foundation estimated diabetes affects 589 million adults globally, 81% of them in low- and middle-income countries.
- Novartis topped the foundation's global health equity ranking again, with AstraZeneca moving up to third place.
- Nearly two-thirds of cancer drugs are covered by measures to make them available in poorer countries, the report found.
The Access to Medicine Foundation, a Netherlands-based nonprofit part-funded by the UK and Dutch governments, warned in its biennial report published on November 10, 2026 that the pharmaceutical industry's focus on GLP-1 weight-loss drugs risks diverting attention from diabetes treatments such as insulin.
GLP-1 medications such as Novo Nordisk's Ozempic and Eli Lilly's Mounjaro have changed obesity and diabetes treatment, but companies have focused more on weight loss, the foundation said. It warned that many people cannot obtain basic insulin, critical for people with type 1 diabetes, and that many countries struggle to access GLP-1 medications at all.
"There is a risk that any of the three – Sanofi, [Eli] Lilly or Novo [Nordisk] – could leave the insulin market, and that will be disastrous for supply to insulin especially for people living with type 1 diabetes and insulin-dependent type 2 diabetes," said Jay Iyer, the foundation's chief executive. He added that attention on GLP-1s is largely directed toward the obesity market and will not help people with type 1 diabetes.
Novo Nordisk has announced plans to phase out some of its older diabetes products, including insulin pens. The foundation said companies can charge far higher prices and enjoy greater profit margins on weight-loss injections and pills than on other medications such as insulin.
The report found that most medications in development in this area focus on type 2 diabetes, and only 10 of the 25 target type 1 diabetes. It estimated that diabetes affects 589 million adults globally, 81% of whom live in low- and middle-income countries such as Pakistan, Egypt and Jordan.
GLP-1 medications are not registered in many lower-income countries, and where available their high price and companies' lack of equitable pricing measures put them out of reach for most people there, the foundation said. The drugs were initially developed to manage type 2 diabetes by regulating blood sugar, slowing digestion and reducing appetite, but their growing use for obesity has opened a large market.
Switzerland's Novartis came top of the foundation's global health equity ranking again after displacing the UK's GSK last time, while AstraZeneca moved up to third place with access plans for almost all its drugs in late-stage development. Nearly two-thirds of cancer drugs are covered by measures to make them available in poorer countries, the report found. Iyer said progress had been made over the last 20 years and access is now part of corporate strategy at some companies, sometimes included in executive bonus targets.