The International Insulin Foundation (IIF) and Health Action International (HAI), among others, publicly opposed the proposal in letters to the WHO’s Selection and Use of Essential Medicines committee.
“Our research shows that median government procurement prices for long-acting insulin can be up to nine times more expensive than intermediate-acting human insulin, while providing limited added value to users,” HAI’s Molly Lepeska told in-PharmaTechnologist.com.
The inclusion of long-acting insulin analogues to the list “would add to existing pressure on national governments to use these newer and vastly more expensive insulins.”
“If governments succumb to this pressure, it will result in fewer people being treated or a dramatic increase in cost to cash-strapped health systems, particularly in low- and middle- income countries,” she said.
HAI’s Addressing the Challenge and Constraints of Insulin Sources and Supply (ACCIS) study is researching the factors that influence prices, and expects to release these findings over the coming months, “which will potentially shed much needed-light on this topic,” said Lepeska.
Long- vs intermediate-acting insulin
Whereas intermediate-acting human insulins typically last between 16 and 20 hours, and are usually taken twice a day, long-acting analogue insulins (basal insulins) can last up to 24 hours in the blood stream, and consequently are taken just once or twice daily.
Long-acting analogue insulin is designed to produce fewer peaks, in order to lower the risk of hypoglycaemia.
However, Lepeska explained “The available research is inconclusive on the topic of whether or not they reduce hypoglycaemia in all cases – likewise on whether or not they offer better clinical results than intermediate-acting human insulin.”
The panel is expected to disclose its decision on whether or not it will include long-acting insulin analogues in WHO’s list at the end of May/early June.