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WHO report: A call to action to promote affordable insulin access

WHO report: A call to action to promote affordable insulin access

  • The World Health Organization (WHO) recently released a report highlighting the disturbing inequities in global access to insulin, related devices, and diabetes care.
  • Some barriers to access include high prices, inadequate availability of human insulin, a limited number of manufacturers, and suboptimal health systems.
  • The report identifies five strategies to address access gaps and inequalities in order to improve the health of people with diabetes requiring insulin worldwide.

WHO Reported Insulin is a hormone that the pancreas produces. It is necessary for the body to utilize or store the blood sugar from the food we eat.

Diabetes occurs when either the pancreas does not produce enough insulin or cells do not respond to the insulin in the body.

Chronically high blood glucose levels due to diabetes may result in long-term complications Report WHO

Such as vision loss, kidney failure, lower limb amputation, heart attack, and strokes. Currently, more than 420 millionTrusted Source people worldwide live with diabetes.

According to the report, globally, about 9 million people with type 1 diabetes rely on insulin for survival, and about 63 million individuals with type 2 diabetes require insulin for treatment.

Although the discovery of insulin in 1921 revolutionized diabetes treatment, inadequate access to insulin and diabetes care in many countries remains a century later.

Considerable access gaps exist, especially in low and middle income countries, despite the increasing burden of diabetes. An estimated 80% of people with diabetes globally live in low and middle income countries.

The recent WHO reportTrusted Source describes the current barriers to insulin access, identifies the causes of these barriers, and suggests strategies to improve access to affordable, safe, and effective insulin and devices globally.

Barriers and causes

Currently, insulin is not affordable or available in many countries. The WHO explained to Medical News Today in an interview that one cause of “unaffordable pricing […] is a market shift from lower-priced human insulin to higher-priced insulin analogues.”

Dr. Kasia Lipska is an associate professor of medicine at the Yale School of Medicine in New Haven, CT. In 2018, she spoke at a panel discussion called “Drug prices in the spotlight: Why are insulin costs rising, and what can be done?”

In it, she explained: “About 15 years ago, a vial of insulin called Humalog cost about $59 per vial. Now, in 2018, that same vial, same insulin, same product costs around $300.”

She added: “That’s happened across lots of different types of insulin, and particularly the […] insulin analogues — the ones that were developed in the 2000s. They’ve increased in price dramatically and exponentially over the past decade or so.”

In an MNT interview, Dr. Ruth Weinstock, Ph.D., president of Medicine & Science for the American Diabetes Association, stated:

“This has caused many individuals to ration their insulin or not take insulin, causing life threatening acute and chronic complications and even death. In the United States, this is a major problem for individuals who do not have health insurance, as well as for those with healthcare coverage that has high copays or high deductibles.”

In an outpatient surveyTrusted Source at the Yale Diabetes Center. 25% of patients with type 1 or type 2 diabetes reported using less insulin due to insulin costs. Three pharmaceutical companies monopolize insulin supply worldwide, promoting noncompetitive pricing, supply, and demand.

These practices discourage the development of biosimilar products, effectively suppressing the competition.

Dr. Weinstock commented: “Devices and supplies used to monitor glucose levels and help direct and adjust
dosing so that insulin is administer safely are also expensive. When glucose is not monitored, insulin therapy cannot be optimized, and both hypoglycemia and serious hyperglycemia can be undetected.”

The WHO told MNT, “The market is characterized by market exclusivity due to patents.

excessive product differentiations, and problematic marketing practices. Manufacturers lock consumers into using high-cost brand-name glucose strips by providing free or low-cost glucose meters. They refer to this as “freemium marketing practice.”

Dr. Weinstock added: “In low and middle income countries, the high cost of insulin. As well as supply and distribution costs, can be prohibitive. There also can be a lack of adequate refrigeration. So insulin cannot be store properly, causing loss of potency in hot weather.”

According to the WHO: “In many countries. Insulin and diabetes care are only available at secondary or tertiary hospitals at a level insufficient to meet the need. Knowledge and competencies of healthcare workers in using insulins and educating patients may not be available.”

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