Current utilization patterns for long-acting insulin analogues including biosimilars among selected Asian countries and the implications for the future.

Journal: Current medical research and opinion

Volume: 37

Issue: 9

Year of Publication: 2021

Affiliated Institutions:  Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom. Faculty of Medicine and Defence Health, Unit of Pharmacology, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur, Malaysia. Department of Periodontology and Implantology, Karnavati University, Gandhinagar, India. Department of Microbiology, Jahangirnagar University, Dhaka, Bangladesh. Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India. Department of Endocrinology, Chittagong Medical College, Chittagong, Bangladesh. Istituto di Ricerche Farmacologiche 'Mario Negri' IRCCS, Milan, Italy. Department of Endocrinology and Metabolism, Chattogram Maa-O-Shishu Hospital Medical College, Agrabad, Chattogram, Bangladesh. BIRDEM General Hospital, Shahbag Square, Dhaka, Bangladesh. Department of Endocrinology and Metabolism, Bangabandhu Sheik Mujib Medical University Hospital, Dhaka, Bangladesh. Department of Obstetrics and Gynaecology, Bangabandhu Sheik Mujib Medical University, Dhaka, Bangladesh. Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh. Department of Physiology, Eastern Medical College, Cumilla, Bangladesh. National Institute of Mental Health (NIMH), Dhaka, Bangladesh. Epsom and St Helier University Hospitals NHS Trust, Carshalton, Surrey, United Kingdom. Handicap International, Kurigram, Bangladesh. Human Resource Department, Square Toiletries Limited, Dhaka, Bangladesh. Department of Dentistry, SP Medical College, Bikaner, Rajasthan, India. Faculty of Economics, Hosei University, Tokyo, Japan. Division of Biology and Public Health, Mokwon University, Daejeon, South Korea. College of Pharmacy, Ewha Womans University, Seoul, South Korea. Friends' Pharmacy, Wisma Kobesi, Malaysia. National Institute of Health, Islamabad, Pakistan. Department of Pharmacy Practice, Faculty of Pharmacy, The University of Lahore, Lahore, Pakistan. Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden. Independent Consumer Advocate, Brunswick, Victoria, Australia.

Abstract summary 

Prevalence rates for diabetes mellitus continue to rise, which, coupled with increasing costs of complications, has appreciably increased expenditure in recent years. Poor glycaemic control including hypoglycaemia enhances complication rates and associated morbidity, mortality and costs. Consequently, this needs to be addressed. Whilst the majority of patients with diabetes have type-2 diabetes, a considerable number of patients with diabetes require insulin to help control their diabetes. Long-acting insulin analogues were developed to reduce hypoglycaemia associated with insulin and help improve adherence, which can be a concern. However, their considerably higher costs have impacted on their funding and use, especially in countries with affordability issues. Biosimilars can help reduce the costs of long-acting insulin analogues thereby increasing available choices. However, the availability and use of long-acting insulin analogues can be affected by limited price reductions versus originators and limited demand-side initiatives to encourage their use. Consequently, we wanted to assess current utilisation rates for long-acting insulin analogues, especially biosimilars, and the rationale for patterns seen, across multiple Asian countries ranging from Japan (high-income) to Pakistan (lower-income) to inform future strategies.Multiple approaches including assessing utilization and prices of insulins including biosimilars among six Asian countries and comparing the findings especially with other middle-income countries.Typically, there was increasing use of long-acting insulin analogues among the selected Asian countries. This was especially the case enhanced by biosimilars in Bangladesh, India, and Malaysia reflecting their perceived benefits. However, there was limited use in Pakistan due to issues of affordability similar to a number of African countries. The high use of biosimilars in Bangladesh, India and Malaysia was helped by issues of affordability and local production. The limited use of biosimilars in Japan and Korea reflects limited price reductions and demand-side initiatives similar to a number of European countries.Increasing use of long-acting insulin analogues across countries is welcomed, adding to the range of insulins available, which increasingly includes biosimilars. A number of activities are needed to enhance the use of long-acting insulin analogue biosimilars in Japan, Korea and Pakistan.

Authors & Co-authors:  Godman Brian B Haque Mainul M Kumar Santosh S Islam Salequl S Charan Jaykaran J Akter Farhana F Kurdi Amanj A Allocati Eleonora E Bakar Muhammed Abu MA Rahim Sagir Abdur SA Sultana Nusrat N Deeba Farzana F Halim Khan M A MA Alam A B M Muksudul ABMM Jahan Iffat I Kamal Zubair Mahmood ZM Hasin Humaira H Munzur-E-Murshid Nahar Shamsun S Haque Monami M Dutta Siddhartha S Abhayanand Jha Pallavi JP Kaur Rimple Jeet RJ Acharya Jitendra J Sugahara Takuma T Kwon Hye-Young HY Bae SeungJin S Khuan Karen Koh Pek KKP Khan Tanveer Ahmed TA Hussain Shahzad S Saleem Zikria Z Pisana Alice A Wale Janney J Jakovljevic Mihajlo M

Study Outcome 

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Statistics
Citations : 
Authors :  34
Identifiers
Doi : 10.1080/03007995.2021.1946024
SSN : 1473-4877
Study Population
Male,Female
Mesh Terms
Asia
Other Terms
Asia;Bangladesh;biosimilars;diabetes;health policies;insulins;long-acting insulin analogues
Study Design
Case Control Trial,Case Study,Cross Sectional Study
Study Approach
Country of Study
Publication Country
England