Constraints and challenges in access to insulin: a global perspective

Area of Science:

• Global Health
• Endocrinology
• Pharmaceutical Policy

Background:

• Limited focus on access to essential diabetes medicines, particularly insulin, contrasts with attention given to communicable diseases.
• Insulin, discovered in 1921, remains globally unattainable for many, impacting diabetes management and survival.
• The UN's commitment to non-communicable diseases and universal drug access has not adequately addressed insulin access issues.

Purpose of the Study:

• To highlight the complex factors contributing to the global unattainability of essential insulin.
• To review the range of issues affecting insulin affordability and availability for individuals and health systems.
• To underscore the need for greater global attention to insulin access for diabetes care.

Main Methods:

• Review of factors influencing insulin pricing, including manufacturers' selling prices, duties, taxes, and supply chain costs.
• Analysis of market dynamics, comparing insulin to other essential medicines like HIV/AIDS drugs.
• Examination of in-country logistical challenges, such as national quantification, distribution, and lower-level health system needs determination.

Main Results:

• High manufacturers' prices, taxes, and supply chain mark-ups significantly impact insulin affordability.
• Unlike other essential medicines, generic or biosimilar insulin production has not improved overall market access.
• Poor national quantification, distribution, and needs assessment hinder insulin availability at lower health system levels.

Conclusions:

• Global access to essential insulin is severely limited by multifaceted economic and logistical barriers.
• Despite insulin's critical role in diabetes survival and management, global efforts to ensure access are insufficient.
• Urgent, focused action is required to address the complex challenges hindering insulin availability and affordability worldwide.