Utilization trend of long-acting insulin analogues including biosimilars across Europe : findings and implications

Background: Diabetes mellitus rates and associated costs continue to rise across Europe enhancing health authority focus on its management. The risk of complications are 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; however, 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 their impact. There are also concerns with different devices between the manufacturers. As a result, 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: Interrogating health authority databases to assess utilization and expenditure patterns for insulins, including biosimilar insulin glargine. Explanations for patterns seen 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 reflecting 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 has 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 availability and use of insulin glargine biosimilars among European countries despite lower costs. This can be addressed.