A Perspective on Global Access to Insulin: A Descriptive Study of the Market, Trade Flows and Prices

A Perspective on Global Access to Insulin: A Descriptive Study of the Market, Trade Flows and Prices

By: D. Beran, R. O. Laing, W. Kaplan, R. Knox, A. Sharma, V. J. Wirtz, J. Frye, M. Ewen
Publication: Diabetic MedicineJune 2019; Vol. 36: 726-33. DOI: https://doi.org/10.1111/dme.13947.

ATTENTION:

Thank you to all our users and visitors. The International Medical Products Price Guide has served as a valuable resource for thousands of users worldwide for nearly 30 years. However, with the most recent data being 9-years old, we have made the difficult decision to retire this website, which will no longer be accessible after June 30th, 2024. Before its retirement, users can download free PDF versions of the content, which are available for the years 1996 to 2015. Please visit www.msh.org for many more tools and resources relating to Pharmaceutical Systems Strengthening and Supply Chain.

Aim

To describe the global insulin market.

Methods

Market intelligence data, United Nations Commodity Trade Statistics for insulin trade, the International Medical Products Price Guide for prices of human insulin and additional web searches were used as data sources. These sources were combined to gain further insight into possible links among market, trade flows and prices. Descriptive statistics and Spearman’s rank order correlation were used for the analysis.

Results

A total of 34 insulin manufacturers were identified. Most countries and territories are reliant on a limited number of supplying countries. The overall median (interquartile range) government procurement price for a 10‐ml, 100‐IU/ml vial during the period 1996–2013 equivalent was US$4.3 (US$ 3.8–4.8), with median prices in Africa (US$ 4.7) and low‐ (US$ 6.9) and low‐ to middle‐ (US$ 4.7) income countries being higher over this period. The relationships between price and quantity of insulin (Spearman’s r=0.046; P>0.1) and number of import links (Spearman’s r=0.032; P>0.1) were weak. The links between price and percentage of total insulin from a country where a ‘big three’ manufacturer produces insulin (Spearman’s r=0.294; P<0.05) and total insulin from the main import link (Spearman’s r=–0.392; P<0.05) were stronger.

Conclusions

This research shows the high variability of insulin prices and the reliance on a few sources, both companies and countries, for global supply. In addressing access to insulin, countries need to use existing price data to negotiate prices, and mechanisms need to be developed to foster competition and security of supply of insulin, given the limited number of truly global producers.