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Cited by 122Pharmaceutical Economics and PolicyDiabetes Management and ResearchDiabetes Treatment and Management

A global perspective on the issue of access to insulin

Open access
Beran, David, Lazo-Porras, Maria, Mba, Camille M., Mbanya, Jean Claude·2021·Diabetologia
DOI 10.1007/s00125-020-05375-2PMC PMC8012321
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Abstract

The discovery of insulin in 1921 changed the prognosis for people with type 1 diabetes. A century later, availability and affordability of insulin remain a challenge in many parts of the globe. Using the WHO’s framework on understanding the life cycle of medicines, this review details the global and national challenges that affect patients’ abilities to access and afford insulin. Current research and development in diabetes has seen some innovations, but none of these have truly been game-changing. Currently, three multinational companies control over 95% of global insulin supply. The inclusion of insulin on the WHO’s Prequalification Programme is an opportunity to facilitate entry of new companies into the market. Many governments lack policies on the selection, procurement, supply, pricing and reimbursement of insulin. Moreover, mark-ups in the supply chain also affect the final price to the consumer. Whilst expenses related to diabetes are mostly covered by insurance in high-income countries, many patients from low- and middle-income countries have to pay out of their own pockets. The organisation of diabetes management within the healthcare system also affects patient access to insulin. The challenges affecting access to insulin are complex and require a wide range of solutions. Given that 2021 marks the centenary of the discovery of insulin, there is need for global advocacy to ensure that the benefits of insulin and innovations in diabetes care reach all individuals living with diabetes. Graphical abstract

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Cited by

Sorted by citations

Authors
Beran, D., Lazo-Porras, M., Mba, C. M., & Mbanya, J. C.
Affiliations
  • University of Geneva (CH)
  • Université de Yaoundé I (CM)
Corresponding author
Mbanya, Jean Claude
ORCID
Venue
Diabetologia
Publisher
Springer Science and Business Media LLC
Published
2021-01-23
Volume
64
Issue
5
Pages
954-962
ISSN
  • 0012-186X (ISSN-L)
  • 1432-0428
DOI
10.1007/s00125-020-05375-2
PMC
PMC8012321
OpenAlex
W3121482008
Cited by
122
References
2
Citations by year
2026: 19 · 2025: 16 · 2024: 18 · 2023: 21 · 2022: 24 · 2021: 24
FWCI
4.24
Type
journal article
Language
en
Open access
Licence
Locations
  • Diabetologia (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Archive ouverte UNIGE (University of Geneva) (publishedVersion, other-oa)
  • Archive ouverte UNIGE (University of Geneva) (submittedVersion, cc-by)
  • Apollo (University of Cambridge) (submittedVersion, cc-by)
  • Apollo
Funders
Leona M. and Harry B. Helmsley Charitable Trust
Topics
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Pharmaceutical Economics and Policy
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Keywords
insulin access, insulin affordability, type 1 diabetes, insulin pricing, health policy, out-of-pocket costs, low- and middle-income countries
MeSH terms
Diabetes Mellitus, Type 1, Health Services Accessibility, Humans, Income, Insulin, Global Health, Drug Costs, History, 20th Century, History, 21st Century

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