Availability and affordability of essential diabetes medications such as insulin are poor in low- and middle-income countries, research shows.
A survey conducted by Australian researchers found that insulin was only available to people with diabetes in half of surveyed pharmacies worldwide.
The availability of metformin and sulphonylureas, commonly used to treat type 2 diabetes, varied across low- and high-income countries.
More than 156,000 adults were involved in the survey, all of whom had been involved in the ongoing PURE study, with 22 countries represented.
Availability of medication was defined as any dose in a pharmacy on the day of the survey, while affordability was defined as total monthly costs at standard doses.
In the UK, insulin and other diabetes medications are free on the NHS, but this is not the case in all countries. Campaigners have long called for governments to take action in increasing availability of these drugs while lowering costs.
The University of Sydney School of Medicine research team found that metformin was available in 88.7% of community pharmacies, but this declined with country income level. Metformin was also the most affordable diabetes medication.
The sulphonylureas glibenclamide and gliclazide were available in 69.3% and 57.9% of pharmacies overall. Again, these numbers decline in lower income countries.
Insulin was the least affordable diabetes medication, and was only available in 48.3% of pharmacies overall. In low-income countries, this figure dropped to 10.3%.
“Data from selected countries hint toward a poor availability for insulin, and reviews have called for greater attention to the availability and affordability of essential medicines for diabetes (especially insulin), a discussion of possible barriers and a need for a global perspective,” said senior author Clara K. Chow, MBBS, FRACP, PhD.
“World Health Organisation (WHO) has set a voluntary target of 80% availability and 50% use of affordable essential medicines to treat noncommunicable diseases in the public and private sectors by 2025,” the researchers noted.
“The analyses presented here suggest that this target is only being consistently met in high-income countries for [oral antihyperglycemic agents] and insulin.
“These data draw further attention to the need for governments to implement strategies to make essential medications for cardiovascular disease and diabetes more widely available and affordable to achieve the WHO target.”
The findings have been published in The Lancet Diabetes &Endocrinology.

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