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Fifty years of independent expert advice on prescription medicines

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12 February 2014

Fifty years of medicines

penicillan bottleIn the past fifty years our knowledge of medicine has increased exponentially, with technological advances that have allowed new and different types of medicine. With each new development, members of ADEC, and later ACPM, have needed to be at the cutting edge of medical practice.

Medicines are no longer restricted to being small chemically synthesised molecules. Monoclonal antibodies (with names ending in 'mab') can now be designed and produced to target many diseases that were previously difficult to treat effectively, such as cancer and rheumatoid arthritis.

And with the success of penicillin and vaccines, many of the mass killers are no longer the threats they once were (although antibiotic resistance is becoming an ever bigger problem). Instead, medicines are being developed to treat emerging viral diseases, and more emphasis is placed on better therapies for cancer and preventing and treating lifestyle diseases such as cardiovascular disease and diabetes.

Insulin - changing over time

Insulin is life-saving for the 122,000 Australians with type 1 diabetes (JDRF website, 2013), and is also used in a similar number of Australians with type 2 diabetes (about 10% of the type 2 diabetes population).

insulin penIn 1963, when ADEC began, insulin isolated from pig and cow pancreases had been in use for several decades, with various chemical modifications creating long-acting insulins. Over the years, insulins became a recurring feature of ADEC meetings, as new advances led to new insulin medicines.

ADEC and insulin: 1974 to 2008

1974 higher purity pig insulin (mono-component insulin)
1978 recommended replacing the two available strengths of insulin with a single strength, 100 U/mL, to make dose calculations easier.
1984 insulin with the same structure as human insulin, but synthesised from pig insulin (human monocomponent insulin).
1985 human insulin produced using bacteria and recombinant DNA technology—the first medicine to be produced in this way.
1986 concern over the number of insulin products containing a fixed combination of short-acting and longacting insulins. Later (1990) recommended restricting ratios to 50:50 and 30:70 to avoid confusion.
1989 ADEC insisted on the pharmaceutical company conducting an educational program when pig insulin was withdrawn from the Australian market for commercial reasons.
1995 first human insulin analogue (insulin lispro) that had a rapid onset of action, useful for administration close to meal times.
2001 insulin solution (insulin aspart, NovoRapid) to be administered using continuous subcutaneous infusion with a pump: ADEC emphasised that only TGA-authorised pumps to be used.
2002-2008 extensions of indications supported for various insulin analogues, both for use in children and for type 2 diabetes.

Photo showing older couple, three children, and a pregnant woman

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