Per a quick google <15% of type 2 diabetics use insulin. I would say this effects more type 1 diabetics than anything. Or are you trying to say peoples lifestyles are leading them to an autoimmune disease?
Regardless, I suspect he meant that more different types of insulin allow diabetics to take insulin in more different ways aka lifestyles. e.g. closed loop CGM vs a daily long acting insulin plus a short acting for meals.
In other words, more T2D patients take insulin than exist in all of the T1D population.
In Novo's case, they have two kinds of long-acting insulin analogue taken 1-2 times per day for both T1 and T2; they have to my knowledge the only ultra-long-acting insulin on the market, taken once every 2-3 days, most appropriate for T2, but also viable for some T1 lifestyles; they have very-rapid-acting insulin for T1 diabetics only, and they have older kinds of insulins appropriate for older patients.
They offer all of these products in good supplies. I've never seen or heard of a Novo product's being unavailable at the pharmacy. So, as far as I can tell, their only influence on insulin prices is downward pressure, not upward pressure. Every new product they produce lowers the price of insulin despite industry-wide changes.
So, with that I dont feel like there really is any competition. A good step forward might be to disallow insurance companies from having 'preferred' brands.
Novo Nordisk's profits have seen a similar rise.
Now, im no economitician, but I'd wager a vial of Fiasp® that there's more than just supply and demand going on here.
> Novo Nordisk also published data for two of their insulin products, NovoLog and NovoLog FlexPen. Since the early 2000s, the CAGRs for the list prices for NovoLog and NovoLog FlexPen (Fig. 7) have been in the range of 9.8–9.9% (22). This translated into large total increases in the list prices: 353% (2001–2016) for a NovoLog vial and 270% (2003–2016) for a FlexPen. In contrast, net prices received by the manufacturer increased at a more modest rate (3–36%) with CAGRs of 0.2–2.1%. Novo Nordisk, Eli Lilly, and Sanofi have reported that rebates have grown rapidly in recent years, representing more than 40% of U.S. gross sales in some cases
[0] - http://care.diabetesjournals.org/content/diacare/41/6/1299.f...
A lot has changed in the last 20 years. A lot of regulatory and insurance law changes. When the law mandates that we pay for all our medicine via 3rd party intermediaries, you can expect a corresponding price increase as those 3rd parties add their intermediary markup.