Utilisation Trend of Long-Acting Insulin Analogues including Biosimilars across Europe: Findings and Implications

Brian Godman*, Magdalene Wladysiuk, Stuart McTaggart, Amanj Kurdi, Eleonora Allocati, Mihajlo Jakovljevic, Francis Kalemeera, Iris Hoxha, Anna Nachtnebel, Robert Sauermann, Manfred Hinteregger, Vanda Marković-Peković, Biljana Tubic, Guenka Petrova, Konstantin Tachkov, Juraj Slabý, Radka Nejezchlebova, Iva Selke Krulichová, Ott Laius, Gisbert SelkeIrene Langner, András Harsanyi, András Inotai, Arianit Jakupi, Svens Henkuzens, Kristina Garuolienė, Jolanta Gulbinovič, Patricia Vella Bonanno, Jakub Rutkowski, Skule Ingeberg, Øyvind Melien, Ileana Mardare, Jurij Fürst, Sean MacBride-Stewart, Carol Holmes, Caridad Pontes, Corinne Zara, Marta Turu Pedrola, Mikael Hoffmann, Vasileios Kourafalos, Alice Pisana, Rita Banzi, Stephen Campbell, Bjorn Wettermark

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)


Background. Diabetes mellitus rates and associated costs continue to rise across Europe enhancing health authority focus on its management. The risk of complications is enhanced by poor glycaemic control, with long-acting insulin analogues developed to reduce hypoglycaemia and improve patient convenience. There are concerns though with their considerably higher costs, but moderated by reductions in complications and associated costs. Biosimilars can help further reduce costs. However, to date, price reductions for biosimilar insulin glargine appear limited. In addition, the originator company has switched promotional efforts to more concentrated patented formulations to reduce the impact of biosimilars. There are also concerns with different devices between the manufacturers. As a result, there is a need to assess current utilisation rates for insulins, especially long-acting insulin analogues and biosimilars, and the rationale for patterns seen, among multiple European countries to provide future direction. Methodology. Health authority databases are examined to assess utilisation and expenditure patterns for insulins, including biosimilar insulin glargine. Explanations for patterns seen were provided by senior-level personnel. Results. Typically increasing use of long-acting insulin analogues across Europe including both Western and Central and Eastern European countries reflects perceived patient benefits despite higher prices. However, activities by the originator company to switch patients to more concentrated insulin glargine coupled with lowering prices towards biosimilars have limited biosimilar uptake, with biosimilars not currently launched in a minority of European countries. A number of activities were identified to address this. Enhancing the attractiveness of the biosimilar insulin market is essential to encourage other biosimilar manufacturers to enter the market as more long-acting insulin analogues lose their patents to benefit all key stakeholder groups. Conclusions. There are concerns with the availability and use of insulin glargine biosimilars among European countries despite lower costs. This can be addressed.

Original languageEnglish
Article number9996193
JournalBioMed Research International
Publication statusPublished - 2021


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