E-DRUG: BMJ Global Health: Challenges constraining insulin access in Delhi, India
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Dear Colleagues
In our latest paper published in *BMJ Global Health*, Warren Kaplan and I
identify a series of challenges constraining the access to insulin -- an
essential, life-saving medicine for people with diabetes -- in the
private-sector market of Delhi, India. This study has revealed complex
relationships between the various components of the Delhi healthcare system
in terms of patients' insulin access.
This is the first study to analyze insulin availability, prices and factors
influencing market competition, supply and uptake of insulin ('market
dynamics') in the private-sector market in any low or middle income
country.
Even in high-income countries such information may not be
available. We employed a mixed methods survey approach: a modified
WHO/HAI standard survey along with qualitative interviews with insulin
retailers (pharmacists) and wholesalers to understand insulin market
dynamics.
Indian pharmaceutical companies have been producing human insulin
(non-analogue) for over a decade, however as this paper shows Indian doctors and patients are largely dependent on foreign-company, expensive insulin. The
insulin availability in the Delhi private-sector was found to be low and the prices appear unaffordable, as compared to the WHO standards.
Furthermore we highlight the transition in utilization from human insulin to more expensive, analogue insulin which has major cost implications for insulin therapy and
diabetes care in India. In our paper, we put forth several recommendations
for stakeholders on how India could not only help improve access to insulin
locally but could also potentially help meet the global unmet insulin need.
Below are the open-access links to the* BMJ Global Health* research article:
Online text: http://gh.bmj.com/content/1/3/e000112
Download PDF: http://gh.bmj.com/content/1/3/e000112.full-text.pdf
Online supplementary appendix:
http://gh.bmj.com/content/bmjgh/1/3/e000112/DC1/embed/inline-supplementary-material-1.pdf?download=true
Some related media articles:
Nature-India:
http://www.natureasia.com/en/nindia/article/10.1038/nindia.2016.134
Deccan Herald:
http://www.deccanherald.com/content/576909/insulin-india-loss-global-trade.html#
This paper is a part of the ACCISS (Addressing the Challenge and
Constraints of Insulin Sources and Supply) project and we are grateful to
ACCISS researchers for their technical support.
Thanks
Abhishek
Abhishek Sharma, BPharm, MPH
Department of Global Health
Center for Global Health and Development
Boston University School of Public Health
801 Massachusetts Ave, 3rd floor, Boston, MA, USA
Associate Health Economist
Precision Health Economics (Evidence Strategy & Generation)
1505 West 2nd Avenue, Suite 302, Vancouver, BC, Canada
http://www.precisionhealtheconomics.com/
abhishek sharma <abhisheksharma0991@gmail.com>