Comment from Raymond Ward

My name is Ray Ward. I am a practicing family physician, and I serve in the Utah House of Representatives - House district 19, serving Bountiful and West Bountiful. I used to write some prescriptions for Insulin glargine and some for insulin detemir. Now the patients that used to do well with detemir have all been forced to switch to glargine. Last Year I had an older patient whose has a hard time remembering and following instructions. She overdosed on her insulin glargine and was admitted to the hospital ina coma because of life threatening hypoglycemia. She was in the ICU for 3 whole days on a glucose drip because thats how long it took for the glargine to clear from her system. If she had been on detemir, it would have cleared from her system in 1 day. After she came out of the hospital - it would have been great to switch her to the detemir, in case it happened again, but that option has been taken away. Please declare the drug in shortage so we can get back to having a manufacture who will be willing to produce detemir again. Some patients clearly do better with this version of insulin. Some prescribers (like me) clearly want to have the option available sometimes (like during pregnancy or when the very long effect of insulin glargine has injured a patient). The medicine has a long and good track record. The only reason we have lost it is that Novo Nordisk has other insulin products that make it a higher profit margin, and the FDAs normal process is so expensive that manufacturers understand that they can't get through it in a way that keeps them in business. The drug is clearly in shortage since it isn't being produced at all. The mission of the FDA is to make sure that safe medications are readily available to patients who need them. I ask that the FDA will please designate insulin detemir as being in shortage so that we can have a chance for this medicine to continue to exist.