Abstract

Introduction

Prevalence rates for diabetes mellitus continue to rise, which, coupled with increasing costs of complications, has appreciably increased expenditure in recent years. Poor glycaemic control including hypoglycaemia enhances complication rates and associated morbidity, mortality and costs. Consequently, this needs to be addressed. Whilst the majority of patients with diabetes have type-2 diabetes, a considerable number of patients with diabetes require insulin to help control their diabetes. Long-acting insulin analogues were developed to reduce hypoglycaemia associated with insulin and help improve adherence, which can be a concern. However, their considerably higher costs have impacted on their funding and use, especially in countries with affordability issues. Biosimilars can help reduce the costs of long-acting insulin analogues thereby increasing available choices. However, the availability and use of long-acting insulin analogues can be affected by limited price reductions versus originators and limited demand-side initiatives to encourage their use. Consequently, we wanted to assess current utilisation rates for long-acting insulin analogues, especially biosimilars, and the rationale for patterns seen, across multiple Asian countries ranging from Japan (high-income) to Pakistan (lower-income) to inform future strategies.

Methodology

Multiple approaches including assessing utilization and prices of insulins including biosimilars among six Asian countries and comparing the findings especially with other middle-income countries.

Results

Typically, there was increasing use of long-acting insulin analogues among the selected Asian countries. This was especially the case enhanced by biosimilars in Bangladesh, India, and Malaysia reflecting their perceived benefits. However, there was limited use in Pakistan due to issues of affordability similar to a number of African countries. The high use of biosimilars in Bangladesh, India and Malaysia was helped by issues of affordability and local production. The limited use of biosimilars in Japan and Korea reflects limited price reductions and demand-side initiatives similar to a number of European countries.

Conclusions

Increasing use of long-acting insulin analogues across countries is welcomed, adding to the range of insulins available, which increasingly includes biosimilars. A number of activities are needed to enhance the use of long-acting insulin analogue biosimilars in Japan, Korea and Pakistan.

中文翻译：

---

选定亚洲国家目前长效胰岛素类似物（包括生物仿制药）的使用模式及其对未来的影响

摘要

介绍

糖尿病的患病率持续上升，加上并发症成本的增加，近年来支出明显增加。血糖控制不佳（包括低血糖）会增加并发症发生率和相关的发病率、死亡率和费用。因此，需要解决这个问题。虽然大多数糖尿病患者患有 2 型糖尿病，但相当多的糖尿病患者需要胰岛素来帮助控制糖尿病。开发了长效胰岛素类似物以减少与胰岛素相关的低血糖并帮助提高依从性，这可能是一个问题。然而，它们相当高的成本影响了它们的资金和使用，特别是在有负担能力问题的国家。生物仿制药可以帮助降低长效胰岛素类似物的成本，从而增加可用的选择。然而，长效胰岛素类似物的可用性和使用可能会受到与原研药相比有限的降价以及有限的需求方鼓励使用的举措的影响。因此，我们希望评估从日本（高收入）到巴基斯坦（低收入）等多个亚洲国家的长效胰岛素类似物（尤其是生物仿制药）的当前利用率，以及所见模式的基本原理，以告知未来的战略。

方法

多种方法，包括评估包括生物仿制药在内的胰岛素在六个亚洲国家的利用率和价格，并将研究结果与其他中等收入国家进行比较。

结果

通常，在选定的亚洲国家中，长效胰岛素类似物的使用越来越多。孟加拉国、印度和马来西亚的生物仿制药尤其体现了这种情况，反映了它们感知到的益处。然而，由于与一些非洲国家类似的负担能力问题，巴基斯坦的使用有限。生物仿制药在孟加拉国、印度和马来西亚的大量使用得益于可负担性和本地生产问题。日本和韩国对生物仿制药的有限使用反映了与一些欧洲国家类似的有限降价和需求方举措。

结论

欢迎各国越来越多地使用长效胰岛素类似物，这增加了可用胰岛素的范围，其中越来越多地包括生物仿制药。在日本、韩国和巴基斯坦，需要开展一些活动来加强长效胰岛素类似物生物仿制药的使用。