This report from Health Action International’s Addressing the Challenge and Constraints of Insulin Sources and Supply (ACCISS) Study provides insights into government procurement of insulin using ACCISS collected data covering a five-year period in 11 low-and middle-income countries: Burkina Faso, Mozambique, Uganda, Comoros, Djibouti, Kyrgyzstan, Lao PDR, Lebanon, Nepal, Pakistan (Punjab Province) and Sri Lanka.

This study was undertaken to better understand procurement practices and prices, and to assess the impact of Novo Nordisk’s differential pricing scheme, the Access to Insulin Commitment (A2IC).

This report includes price data, as well as insights into the procurement processes in the aforementioned countries.

From these results, key finding included:

• Governments procure in different ways, which impacts the prices paid.
• Biosimilars can offer savings for both human and analogue insulins. However, some low- and middle-income countries (LMICs) procure human insulin solely from Novo Nordisk.
• Governments and other national informants were largely unaware of Novo Nordisk’s Access to Insulin Commitment (A2IC) for human insulin in vials. Novo Nordisk did not always submit tender bids in A2IC eligible countries and some countries paid far less, or far more, than the A2IC ceiling price.
• Sanofi’s not-for-profit Insulin Glargine Impact brand offered significant savings compared to Lantus, but the price remained high.
• There is little transparency in selling and buying prices in the insulin market.

Download the report (in PDF)