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The Current Situation Regarding Long-Acting Insulin Analogues Including Biosimilars Among African, Asian, European, and South American Countries; Findings and Implications for the Future

Bibliographic Data

ID22070752
AuthorsBrian Godman (0000-0001-6539-6972, Universiti Sains Malaysia, corresponding author), Mainul Haque (0000-0002-6124-7993, Centre for the Rehabilitation of the Paralysed), Trudy Desirie D Leong (0000-0003-2687-7751, Department of Health), Trudy Leong, Eleonora Allocati (0000-0002-6917-1495, Mario Negri Institute for Pharmacological Research), Santosh Kumar (0000-0002-8663-3006, Karnavati University), Salequl Islam (0000-0001-6131-4132, Jahangirnagar University), Jaykaran Charan (0000-0002-4857-6725, All India Institute of Medical Sciences Jodhpur), Farhana Akter (0000-0002-4488-9388, Chittagong Medical College), Amanj Kurdi (0000-0001-5036-1988, Hawler Medical University), Carlos Vassalo (Universidad Nacional del Litoral), Muhammed Abu Bakar (0000-0003-3127-3522, Chattagram Maa-O-Shishu Hospital Medical College), Sagir Abdur Rahim, Md Jawadur Rahim (0000-0002-4601-6417, Bangladesh Institute of Research and Rehabilitation for Diabetes Endocrine and Metabolic Disorders), Nusrat Sultana (0000-0002-6858-2110, Bangladesh Medical University), Farzana Deeba (0000-0001-8434-6292, Bangladesh Medical University), M A Halim Khan, Muhammad Arslan Khan (Shaheed Suhrawardy Medical College), A B M Muksudul Alam (0000-0002-7309-8382, Shaheed Suhrawardy Medical College), Iffat Jahan (0000-0001-5615-7013, Eastern Medical College and Hospital), Zubair Mahmood Kamal (0000-0001-9659-2925), Humaira Hasin (Epsom and St Helier University Hospitals NHS Trust), Munzur-E-Murshid Munzur-E-Murshid, Shamsun Nahar (0009-0001-1660-4824, Jahangirnagar University), Monami Haque (0000-0002-7970-6094, Centre for the Rehabilitation of the Paralysed), Siddhartha Dutta (0000-0001-6525-5950, All India Institute of Medical Sciences Jodhpur), Jha Pallavi Abhayanand (0000-0002-6936-3315, All India Institute of Medical Sciences Jodhpur), Rimple Jeet Kaur (0000-0003-4478-1411, All India Institute of Medical Sciences Jodhpur), Godfrey Mutashambara Rwegerera (0000-0002-5896-6065, University of Botswana), Renata Cristina Rezende Macedo Do Nascimento (0000-0001-7756-2157, Universidade Federal de Ouro Preto), Isabella Piassi Dias Godói (0000-0002-0568-6625, Universidade Federal do Sul e Sudeste do Pará), Mohammed Irfan (0000-0003-0683-106X, Universidade Federal de Pelotas), Adefolarin A Amu (Southern Africa Nazarene University), Patrick Matowa, Patrick Rutendo Matowa (0000-0002-3022-7623, Southern Africa Nazarene University), Joseph Acolatse, Joseph Elikem Efui Acolatse (0000-0001-6556-3208), Robert Incoom, Israel Abebrese Sefah (0000-0001-6963-0519, University of Health and Allied Sciences), Jitendra Acharya (Sardar Patel Medical College), Sylvia Opanga (University of Nairobi), Lisper Wangeci Njeri (0000-0002-1559-2788, Kenyatta National Hospital), David Kimonge (University of Nairobi), Hye-Young Kwon (0000-0001-9772-1354, Mokwon University), SeungJin Bae (0000-0002-8993-8884, Ewha Womans University), Karen Koh Pek Khuan, Abdullahi Rabiu Abubakar (0000-0002-9740-7856, Bayero University Kano), Ibrahim Sani (0000-0001-7489-8253, Maitama Sule University Kano), Ibrahim Haruna Sani, Tanveer Khan (0000-0001-5970-3972, National Institute of Health), Tanveer Ahmed Khan, Shahzad Hussain (0000-0003-1038-5314, National Institute of Health), Zikria Saleem (0000-0003-3202-6347, University of Lahore), Oliver Ombeva Malande (0000-0002-1840-7402, Egerton University), Thereza Piloya-Were, Thereza Piloya (0000-0002-9818-093X, Makerere University), Rosana Gambogi (0000-0003-0781-7745), Carla Hernandez Ortiz (0009-0000-3726-5692), Luke Alutuli (University Teaching Hospital), Aubrey C Kalungia (0000-0003-2554-1236, University of Zambia), Iris Hoxha (University of Medicine Tirana), Vanda Marković-Peković, Vanda Marković‐Peković (0000-0001-8963-5720, University of Banja Luka), Biljana Tubic (0000-0002-0527-6327, University of Banja Luka), Guenka Petrova (0000-0001-8116-5138, Medical University of Sofia), Konstantin Tachkov (0000-0002-3961-7556, Medical University of Sofia), Ott Laius (0000-0003-3828-1373), András Harsanyi (Eötvös Loránd University), András Inotai (0000-0002-0663-2733, Semmelweis University), Arianit Jakupi (0000-0002-7719-9690, University for Business and Technology), Svens Henkuzens, Kristina Garuoliene (0000-0001-7910-0108, Vilnius University), Jolanta Gulbinovič (0000-0003-3776-6934, Vilnius University), Magdalene Wladysiuk (Jagiellonian University), Jakub Rutkowski (CRE Consulting (Poland)), Ileana Mardare (0000-0002-4725-9808, Carol Davila University of Medicine and Pharmacy), Jurij Fürst (Health Insurance Institute of Slovenia), Stuart McTaggart (0000-0001-6060-9019, Public Health Scotland), Sean MacBride-Stewart, Seán MacBride‐Stewart (0000-0002-2553-5939, NHS Greater Glasgow and Clyde), Caridad Pontes (0000-0002-3274-6048, Universitat Autonòma de Barcelona), Corinne Zara (0000-0002-6831-2233), Eunice Twumwaa Tagoe (University of Strathclyde), Rita Banzi (0000-0002-2211-3300, Mario Negri Institute for Pharmacological Research), Janney Wale, Mihajlo Jakovljević (0000-0002-9160-6846, University of Kragujevac)
Year2021
Volume9
Pages671961-671961
Publication date2021-06-24
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2021.671961
PMID34249838
OpenAlexW3177155779
LanguageEN
Citations received2
References cited135

Background: Diabetes mellitus rates continue to rise, which coupled with increasing costs of associated complications has appreciably increased global expenditure in recent years. The risk of complications are enhanced by poor glycaemic control including hypoglycaemia. Long-acting insulin analogues were developed to reduce hypoglycaemia and improve adherence. Their considerably higher costs though have impacted their funding and use. Biosimilars can help reduce medicine costs. However, their introduction has been affected by a number of factors. These include the originator company dropping its price as well as promoting patented higher strength 300 IU/ml insulin glargine. There can also be concerns with different devices between the manufacturers. Objective: To assess current utilisation rates for insulins, especially long-acting insulin analogues, and the rationale for patterns seen, across multiple countries to inform strategies to enhance future utilisation of long-acting insulin analogue biosimilars to benefit all key stakeholders. Our approach: Multiple approaches including assessing the utilisation, expenditure and prices of insulins, including biosimilar insulin glargine, across multiple continents and countries. Results: There was considerable variation in the use of long-acting insulin analogues as a percentage of all insulins prescribed and dispensed across countries and continents. This ranged from limited use of long-acting insulin analogues among African countries compared to routine funding and use across Europe in view of their perceived benefits. Increasing use was also seen among Asian countries including Bangladesh and India for similar reasons. However, concerns with costs and value limited their use across Africa, Brazil and Pakistan. There was though limited use of biosimilar insulin glargine 100 IU/ml compared with other recent biosimilars especially among European countries and Korea. This was principally driven by small price differences in reality between the originator and biosimilars coupled with increasing use of the patented 300 IU/ml formulation. A number of activities were identified to enhance future biosimilar use. These included only reimbursing biosimilar long-acting insulin analogues, introducing prescribing targets and increasing competition among manufacturers including stimulating local production. Conclusions: There are concerns with the availability and use of insulin glargine biosimilars despite lower costs. This can be addressed by multiple activities

Biosimilar · Business · Environmental health · Hypoglycemia · Insulin · Insulin glargine · Biosimilars and Bioanalytical Methods · Medicine · Pharmaceutical Economics and Policy · Pharmaceutical studies and practices · Endocrinology · Internal Medicine

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Unique citing works2
Citations per year0,5
Citation span2022 - 2025 (4)
Citation velocityrecent
Highly citedNo
Citation typesNeutral: 2

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