Kenyans not getting the insulin they need – Report

 A new report has shown that people with diabetes in Kenya and other poor countries are not currently getting the choice of insulin they need.

In 2021, Kenya was ranked by the International Diabetes Federation as the 31st African country in terms of diabetes with a prevalence of about 460 diabetic cases per 10,000 population.

The report says only 29 of the 108 countries in scope – including Kenya – have all the insulins classified as “essential medicines” by WHO registered, and only one of those is a low-income country.

The report also identifies ways in which insulin producers are seeking sustainable approaches to scaling up access.

The three companies that dominate the global insulin market – Eli Lilly, Novo Nordisk and Sanofi – are pursuing a patchwork of strategies to expand access to their products in LMICs.

The Access to Medicine Foundation's report is titled: What are pharma companies doing to expand access to insulin – and how can efforts be scaled up?

It also examines initiatives from biosimilar manufacturer Biocon, shedding light on the potential role of biosimilar insulins in improving affordability and widening access.

Biosimilars are more like generics.

“While diabetes care has advanced since the discovery of insulin 100 years ago, this highly effective drug, and the range of products that help manage chronic diabetes, is only available to a fortunate few,” said Jayasree K. Iyer, CEO, Access to Medicine Foundation, in a statement.  

The number of people with diabetes worldwide is expected to reach 643 million by 2030, and 700 million by 2045 – rising most rapidly LMICs, where there is stark inequity in access to insulin.

It is vital that people with diabetes have access to a reliable and affordable supply of insulin in order to stay alive and healthy.

Yet, in many countries, people still do not have access to human insulin – a form of insulin that was discovered almost half a century ago.

In addition to human insulin, people living with diabetes in LMICs should have access to the analogue insulin products that have become well-established and preferred by patients and healthcare professionals in higher-income countries over recent decades.

Analogue insulins can allow for improved control of blood sugar levels after meals and overnight – making patients' lives easier, reducing the risk of hypoglycaemia (low blood glucose levels), and potentially increasing adherence to treatment. However, these products can cost over two to six times more than human insulins, with prices varying significantly between countries.

“Insulin products, particularly analogue insulins, need to become affordable to every payer. Tapping into the promising potential of biosimilar insulins, for example, could expand affordability and access. While access to insulin is a complex, multifaceted issue, more efforts are needed on a greater scale, covering a wider range of products,” Claudia Martínez, research programme manager, Access to Medicine Foundation.

The World Health Organization (WHO) has already recognised the importance of analogue insulins, and not just human insulins, by adding several analogues and their biosimilars to the WHO Model List of Essential Medicines in 2021, a firm indication that they should be available to patients in every country.