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One In Two Diabetics Lacks Access To Insulin In India

Drug is scarce in public hospitals, and costly at private pharmacies, says survey

One in two people needing insulin in India lack access to it, and the public hospitals in some States may be reeling under an intermittent shortage of insulin, a research paper published in British Medical Journal Global Health (BMJ) has said.

In 2016, the authors undertook price and availability surveys in Brazil, China, Ethiopia, Ghana, India, Indonesia, Jordan, Kenya, Kyrgyzstan, Mali, Pakistan, Russia and Uganda. Public hospitals, private retail pharmacies and private hospitals and clinics were surveyed.

In Pakistan, all the three types of human insulin were well available across all the three sectors, which was not the case in the other countries, said the paper, titled ‘Insulin prices — availability and affordability in 13 low-income and middle-income countries’.

For example, in Haryana, where insulin is provided for free in the public sector, it was not found in the State and district public hospitals, said the paper. Only short-acting insulin was in stock in the teaching hospital in Chandigarh, it added.

The limitations of the paper, by its own admission, are that it is based on a one-time survey made in Haryana and Madhya Pradesh.

Storage issues

Jan Swasthya Sahyog co-founder Yogesh Jain, who runs a rural hospital in Chhattisgarh, said not all is well with insulin supply in villages. Often, the kind of insulin needed is not available. For example, the 30/70 human insulin is quite scarce in the public sector. “We run a rural outpost in the interiors of Bilaspur and procure our own stocks of insulin. We have written to the State government to make insulin available in remote areas but they do not agree. Even insulin storage at home is an issue due to lack of refrigerators,” said Jain.

The BMJ paper said nearly all types of insulin were available in private pharmacies even as public hospitals reeled under a shortage. For example, the 30/70 human insulin was available for up to 417 a vial in originator brands and biosimilars. “A low-income person had to work four and seven days to buy 10 ml of human and analogue insulin, respectively,” the paper said.

“Discussions with several (drug) companies revealed they were manufacturing (insulin) below maximal capacity that impacts unit prices and their ability to compete with the multinationals,” it added.- The Hindu Business Line