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

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...

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Published in:	Frontiers in public health Vol. 9
Main Authors:	Godman, Brian, Haque, Mainul, Leong, Trudy, Allocati, Eleonora, Kumar, Santosh, Islam, Salequl, Charan, Jaykaran, Akter, Farhana, Kurdi, Amanj, Vassalo, Carlos, Bakar, Muhammed Abu, Rahim, Sagir Abdur, Sultana, Nusrat, Deeba, Farzana, Khan, M. A. Halim, Alam, A. B. M. Muksudul, Jahan, Iffat, Kamal, Zubair Mahmood, Hasin, Humaira, Munzur-E-Murshid, Nahar, Shamsun, Haque, Monami, Dutta, Siddhartha, Abhayanand, Jha Pallavi, Kaur, Rimple Jeet, Rwegerera, Godfrey Mutashambara, Nascimento, Renata Cristina Rezende Macedo do, Dias Godói, Isabella Piassi, Irfan, Mohammed, Amu, Adefolarin A., Matowa, Patrick, Acolatse, Joseph, Incoom, Robert, Sefah, Israel Abebrese, Acharya, Jitendra, Opanga, Sylvia, Njeri, Lisper Wangeci, Kimonge, David, Kwon, Hye-Young, Bae, SeungJin, Khuan, Karen Koh Pek, Abubakar, Abdullahi Rabiu, Sani, Ibrahim Haruna, Khan, Tanveer Ahmed, Hussain, Shahzad, Saleem, Zikria, Malande, Oliver Ombeva, Piloya-Were, Thereza, Gambogi, Rosana, Hernandez Ortiz, Carla, Alutuli, Luke, Kalungia, Aubrey Chichonyi, Hoxha, Iris, Marković-Peković, Vanda, Tubic, Biljana, Petrova, Guenka, Tachkov, Konstantin, Laius, Ott, Harsanyi, András, Inotai, András, Jakupi, Arianit, Henkuzens, Svens, Garuoliene, Kristina, Gulbinovič, Jolanta, Wladysiuk, Magdalene, Rutkowski, Jakub, Mardare, Ileana, Fürst, Jurij, McTaggart, Stuart, MacBride-Stewart, Sean, Pontes, Caridad, Zara, Corinne, Tagoe, Eunice Twumwaa, Banzi, Rita, Wale, Janney, Jakovljevic, Mihajlo
Format:	Journal Article
Language:	English
Published:	Frontiers Media S.A 24-06-2021
Subjects:	Africa biosimilars cross-national study drug utilisation Europe health policy Public Health
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Summary:	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.
Bibliography:	Salequl Islam orcid.org/0000-0001-6131-4132 Jha Pallavi Abhayanand orcid.org/0000-0002-6936-3315 Muhammed Abu Bakar orcid.org/0000-0003-3127-3522 Jaykaran Charan orcid.org/0000-0002-4857-6725 Santosh Kumar orcid.org/0000-0002-5117-7872 Nusrat Sultana orcid.org/0000-0002-6858-2110 Jolanta Gulbinovič orcid.org/0000-0003-3776-6934 Farzana Deeba orcid.org/0000-0001-8434-6292 Joseph Acolatse orcid.org/0000-0001-6556-3208 Hye-Young Kwon orcid.org/0000-0001-9772-1354 Abdullahi Rabiu Abubakar orcid.org/0000-0002-9740-7856 Iffat Jahan orcid.org/0000-0003-0551-3609 Edited by: Roza Adany, University of Debrecen, Hungary Sean MacBride-Stewart orcid.org/0000-0002-2553-5939 ORCID: Brian Godman orcid.org/0000-0001-6539-6972 Amanj Kurdi orcid.org/0000-0001-5036-1988 Isabella Piassi Dias-Godói orcid.org/0000-0002-0568-6625 Michael Jakovljevic orcid.org/0000-0002-9160-6846 Zubair Mahmood Kamal orcid.org/0000-0001-9659-2925 Rosana Gambogi orcid.org/0000-0003-0781-7745 A. B. M. Muksudul Alam orcid.org/0000-0002-7309-8382 Ibrahim Haruna Sani orcid.org/0000-0003-1153-5900 Caridad Pontes orcid.org/0000-0002-3274-6048 M. A. Halim Khan orcid.org/0000-0002-3459-270 Mohammed Irfan orcid.org/0000-0003-0683-106X Adefolarin A. Amu orcid.org/0000-0003-3212-2283 Siddhartha Dutta orcid.org/0000-0001-6525-5950 Arianit Jakupiorcid.org/0000-0002-7719-9690 Zikria Saleem orcid.org/0000-0003-3202-6347 This article was submitted to Health Economics, a section of the journal Frontiers in Public Health Eunice Twumwaa Tagoe orcid.org/0000-0002-2198-4980 Monami Haque orcid.org/0000-0002-7970-6094 Lisper Wangeci Njeri orcid.org/0000-0002-1559-2788 Shamsun Nahar orcid.org/0000-0002-3580-5576 Ileana Mardare orcid.org/0000-0002-4725-9808 Reviewed by: Mohamed Izham Mohamed Ibrahim, Qatar University, Qatar; Piotr Romaniuk, Medical University of Silesia, Poland; Michael Ekubu Otim, University of Sharjah, United Arab Emirates Mainul Haque orcid.org/0000-0002-6124-7993 Farhana Akter orcid.org/0000-0002-4488-9388 Israel Abebrese Sefah orcid.org/0000-0001-6963-0519 Aubrey Chichonyi Kalungia orcid.org/0000-0003-2554-1236 Karen Koh Pek Khuan orcid.org/0000-0002-3634-2083 Munzur-E-Murshid orcid.org/0000-0001-5503-7757 Thereza Piloya-Were orcid.org/0000-0002-9818-093X Rita Banzi orcid.org/0000-0002-2211-3300 Rimple Jeet Kaur orcid.org/0000-0003-4478-1411 Trudy Leong orcid.org/0000-0003-2687-7751 Sagir Abdur Rahim orcid.org/0000-0002-4601-6417 Humaira Hasin orcid.org/0000-0002-7736-3315 Renata Cristina Rezende Macedo do Nascimento orcid.org/0000-0001-7756-2157 SeungJin Bae orcid.org/0000-0002-8993-8884 Corrine Zara orcid.org/0000-0002-6831-2233 Godfrey Mutashambara Rwegerera orcid.org/0000-0002-5896-6065 Vanda Marković-Peković orcid.org/0000-0001-8963-5720
ISSN:	2296-2565 2296-2565
DOI:	10.3389/fpubh.2021.671961