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Member Research & Reports

Member Research & Reports

BU Finds Access to Insulin in India Constrained by Costs, Lack of Market Competition

Most patients in India, including those with diabetes, seek health care in the private sector through out-of-pocket payments. A lack of market competition, direct sales that bypass pharmacies, and a move toward more expensive analogue insulin are creating significant barriers to access, says a new study authored by Boston University School of Public Health (BUSPH) researchers.

The study in BMJ Global Health assessed insulin availability and prices in Delhi state in India through surveys and interviews. It found that the mean availability of human insulin in the pharmacy outlets analyzed was 44 percent (i.e. 44 percent of the pharmacies surveyed carried human insulin), and for the more expensive analogue insulin, just 13 percent. This was far lower than the World Health Organization’s availability target of 80 percent.

Besides the lack of availability, the study found that insulin prices were essentially “unaffordable” for most Indian patients. Consumers paid as much as 128 percent over insulin import prices because of supply chain mark-ups, taxes, and other costs.

“The Delhi insulin market is an oligopoly, and such limited market competition has implications for suppliers’ incentives to meet patients’ need and for insulin prices and usage in lower income countries,” says the study authors, which include BUSPH alumnus Mr. Abhishek Sharma and Dr. Warren Kaplan, BUSPH clinical assistant professor of global health.

To read more about the study, go to: