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Netherlands-based NGO reveals global gaps in insulin access

India is home to 77 million people suffering with diabetes, and over half a billion worldwide have the disease. (Photo: iStock)Premium
India is home to 77 million people suffering with diabetes, and over half a billion worldwide have the disease. (Photo: iStock)

Cost is a huge barrier to insulin access in LMICs. Human insulins are still out of the reach of many people with diabetes. When available, analogues are very expensive and can cost two to six times more than human insulins. There are also wide variations in price across countries

NEW DELHI: There are gaps, globally, in access to insulin despite the anti-diabetic therapy having been around for 100 years, according to a paper published by Access to Medicine Foundation (ATMF), an NGO based in the Netherlands.

While guiding pharmaceutical companies manufacturing insulin to do more for people living in low- and middle-income countries (LMICs), the paper called for reversing the existing inequity of insulin by expanding their medicine access globally.

“Despite being discovered over a 100 years ago, less than 30% of LMICs currently have access to all insulins deemed essential. Human insulins are by far the most broadly available, yet in many low-income countries (LICS) gaps remain. When it comes to analogues, our research finds that these products are registered in a smaller number of LMICs (only 2/3s of LMICs in scope) and that, in LICs, the poorest people systematically miss out on access," Access to Medicine Foundation (ATMF) spokesperson told Mint.

India is home to 77 million people suffering with diabetes, and over half a billion worldwide have the disease, with the number expected to reach 700 million by 2045.

The report has revealed that an estimated 72 million people, including 9 million with type 1 diabetes, require insulin.

Out-of-pocket expenditure due to the disease amounted to $966 billion the last year.

“The cost of insulin remains a huge barrier to access in LMICs. Human insulins are still out of the reach of many people with diabetes. When available, analogues are very expensive and can cost two to six times more than human insulins. There are also wide variations in price across countries. For instance, the same brand of analogue insulin (Lantus pen) was found to cost $21.5 in Indonesia but over $105 in China. Tapping into the promising potential of biosimilar insulins, for example, could expand affordability and access," the spokesperson said.

While access to insulin is a complex, multifaceted issue, more efforts are needed on a greater scale, covering a wider range of products. Insulin donation programmes, paediatric programmes, and other small-scale projects that are being carried out in specific countries are indeed making a difference for people living with diabetes in LMICs, but this is not enough to fully tackle the extent of this problem and system-level approaches need to be implemented more systematically, ATMF suggested.

The report said that currently drug makers are following a patchwork approach focusing on a small number of countries based around particular types of products and population suggesting ways how accessibility of insulin can be increased.

“Companies like Biocon Biologics, which focus specifically on developing, manufacturing and marketing biosimilar human insulin and insulin analogues, could play a big role in bringing in equitable access to insulins. Biocon’s human insulins is registered by in two fifths of upper middle-income countries and one fifth of low-income countries," the report said.

Talking to Mint, Biocon Biologics’ deputy CEO, Shreehas Tambe, said, “Biocon Biologics is engaged in addressing the global challenge of insulin inequity by supplying its affordable, yet high quality biosimilar insulins to low- and middle-income countries (LMICs). Through our patient-centric approach and a comprehensive portfolio of biosimilar insulins and devices, we are aiming to address current issues around insulin access, availability and affordability in both emerging and developed markets.

The ATMF report said that biosimilar insulin is equivalent to innovator insulins in terms of quality, efficacy, safety, and immunogenicity, and holds huge potential in expanding the choice of insulins in LMICs.

The company has supplied over 2.75 billion doses of rh-Insulin globally since 2004, registering its presence in over 70 countries. Recently, the firm has received regulatory approvals for Insulin Aspart in EU and Canada respectively.

A spokesperson of Novo Nordisk said, “We are proud of our efforts in the field of insulin. Last year, we reached 5 million vulnerable people with diabetes. This corresponds to 14% of all the people with diabetes we reach with our products. This does not happen by itself, but because we prioritize significant investments and resources in this area. We view the ATMF as one of many important partners in our efforts to bring medicines to even more people. We are in ongoing dialogue with them as we learn from them and vice versa."

ABOUT THE AUTHOR

Priyanka Sharma

Priyanka Shamra is a health and pharma journalist with nearly nine years of field reporting experience. She is a special correspondent with Mint. Her beat includes covering the Ministry of Health and Department of Pharmaceuticals. She also covers the Ministry of Women and Child Development and the Department of Biotechnology.
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