On 11 May, 2010, people from 60 countries collected data on the price a patient would have to pay (if they paid the full price) for a 10 ml traditional vial of 100IU/ml soluble human insulin injection (neutral, regular) in their closest private retail pharmacy. This one-day snapshot of the price of insulin is the second in the series; on 30 November, 2009, a snapshot was taken on the price of a course of ciprofloxacin 500mg tablets.

The map above shows prices in US dollars for each brand of soluble human insulin (10ml traditional vial only) found in the pharmacy on 11 May, 2010. If you click on the ‘bubble’, a text box will give the location, brand, manufacturer and price of the insulin. Unlike the snapshot of ciprofloxacin prices, in the map, all brands of insulin have been considered as originator brands. (It appears that Eli Lilly and Novo Nordisk first marketed insulin at about the same time.)

These prices should not be considered to be representative of the situation in a given country since great price variation exists within some countries. They are, however, indicative of what patients would have to pay, if paying the full retail price, in those pharmacies on that day.

As can be seen on the map, prices vary considerably across countries and between brands—from US$1.55 in Iran to US$76.69 in Austria —a difference of almost 5000 percent. While patient prices are often lower in low-income countries, the prices in some low- and middle-income countries are higher than in high-income countries. Even when prices are lower, insulin is still unaffordable for those on low incomes (which is often the majority of the population), resulting in dire consequences for people with diabetes if they cannot afford to buy the medicine.

About ninety years after its discovery, access to insulin is beyond the reach of millions of people with diabetes around the world. Access to insulin is an essential and non-negotiable need—a matter of life or death. Governments need to examine access to affordable insulin and give it the priority it deserves.

The first step is understanding the medicine price, availability and affordability situation, for example through undertaking a medicine price and availability survey, then identifying the causes of high prices and poor availability, developing and implementing policies and strategies, and monitoring their impact to ensure patients benefit from lower prices and improved availability.