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

2021 ◽  
Vol 2021 ◽  
pp. 1-16
Author(s):  
Brian Godman ◽  
Magdalene Wladysiuk ◽  
Stuart McTaggart ◽  
Amanj Kurdi ◽  
Eleonora Allocati ◽  
...  
Keyword(s):  
Insulin Glargine ◽  
Health Authority ◽  
Insulin Analogues ◽  
European Countries ◽  
Acting Insulin ◽  
Promotional Efforts ◽  
Eastern European Countries ◽  
Future Direction ◽  
Long Acting ◽  
The Impact

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.

scholarly journals Insulin degludec is a new ultra-long-acting insulin analogue

2014 ◽  
Vol 17 (2) ◽  
pp. 91-104 ◽  
Author(s):  
Ivan Ivanovich Dedov ◽  
Marina Vladimirovna Shestakova
Keyword(s):  
Glycemic Control ◽  
Insulin Glargine ◽  
Insulin Analogue ◽  
Insulin Analogues ◽  
Insulin Degludec ◽  
Treat To Target ◽  
Nocturnal Hypoglycaemia ◽  
Acting Insulin ◽  
Long Acting

Achieving optimal glycemic control is an important aspect of preventing and slowing the progression of diabetes-associated complications, and reducing the cost of their treatment. Long-acting insulin analogues, glargine and detemir, provide better metabolic control with reduced risk of hypoglycaemia as compared to NPH insulin. However, fear of hypoglycaemia and weight gain, as well as the complexity of regimen, are still the most important barriers to well-timed initiation and intensification of insulin therapy. Insulin degludec (Tresiba?) is a new ultra-long-acting insulin analogue. After subcutaneous injection degludec forms repository of soluble multi-hexamers, which are gradually absorbed to the bloodstream, providing a flat, stable antihyperglycemic effect lasting more than 42 h, and low intra-individual variability as opposed to currently used basal insulin analogues, insulin glargine and insulin detemir. In the seven randomized, open label, controlled phase 3 trials lasting 26 or 52 weeks, using treat-to-target (no more) non-inferiority design, insulin degludec provided glycemic control similar to that of insulin glargine with lower risk of nocturnal hypoglycaemia and good safety profile in patients with type 1 or 2 diabetes. Furthermore, trials examining a flexible dosing regimen of insulin degludec in patients with type 1 or 2 diabetes have shown that it is possible to vary the injection time without compromising glycemic control or safety of the therapy.

scholarly journals The Current Situation Regarding Long-Acting Insulin Analogues Including Biosimilars Among African, Asian, European, and South American Countries; Findings and Implications for the Future

2021 ◽  
Vol 9 ◽  
Author(s):  
Brian Godman ◽  
Mainul Haque ◽  
Trudy Leong ◽  
Eleonora Allocati ◽  
Santosh Kumar ◽  
...  
Keyword(s):  
Insulin Glargine ◽  
Insulin Analogues ◽  
South American ◽  
African Countries ◽  
Poor Glycaemic Control ◽  
Acting Insulin ◽  
Number Of Factors ◽  
Key Stakeholders ◽  
Long Acting ◽  
Price Differences

Background: Diabetes mellitus rates continue to rise, which coupled with increasing costs of associated complications has appreciably increased global expenditure in recent years. The risk of complications are enhanced by poor glycaemic control including hypoglycaemia. Long-acting insulin analogues were developed to reduce hypoglycaemia and improve adherence. Their considerably higher costs though have impacted their funding and use. Biosimilars can help reduce medicine costs. However, their introduction has been affected by a number of factors. These include the originator company dropping its price as well as promoting patented higher strength 300 IU/ml insulin glargine. There can also be concerns with different devices between the manufacturers.Objective: To assess current utilisation rates for insulins, especially long-acting insulin analogues, and the rationale for patterns seen, across multiple countries to inform strategies to enhance future utilisation of long-acting insulin analogue biosimilars to benefit all key stakeholders.Our approach: Multiple approaches including assessing the utilisation, expenditure and prices of insulins, including biosimilar insulin glargine, across multiple continents and countries.Results: There was considerable variation in the use of long-acting insulin analogues as a percentage of all insulins prescribed and dispensed across countries and continents. This ranged from limited use of long-acting insulin analogues among African countries compared to routine funding and use across Europe in view of their perceived benefits. Increasing use was also seen among Asian countries including Bangladesh and India for similar reasons. However, concerns with costs and value limited their use across Africa, Brazil and Pakistan. There was though limited use of biosimilar insulin glargine 100 IU/ml compared with other recent biosimilars especially among European countries and Korea. This was principally driven by small price differences in reality between the originator and biosimilars coupled with increasing use of the patented 300 IU/ml formulation. A number of activities were identified to enhance future biosimilar use. These included only reimbursing biosimilar long-acting insulin analogues, introducing prescribing targets and increasing competition among manufacturers including stimulating local production.Conclusions: There are concerns with the availability and use of insulin glargine biosimilars despite lower costs. This can be addressed by multiple activities.

scholarly journals Time-action profile of the long-acting insulin analog insulin glargine (HOE901) in comparison with those of NPH insulin and placebo

Diabetes Care ◽  
2000 ◽  
Vol 23 (5) ◽  
pp. 644-649 ◽  
Author(s):  
L. Heinemann ◽  
R. Linkeschova ◽  
K. Rave ◽  
B. Hompesch ◽  
M. Sedlak ◽  
...  
Keyword(s):  
Insulin Glargine ◽  
Insulin Analog ◽  
Nph Insulin ◽  
Acting Insulin ◽  
Analog Insulin ◽  
Long Acting ◽  
Action Profile

scholarly journals Lower Glucose Variability and Hypoglycemia Measured by Continuous Glucose Monitoring With Novel Long-Acting Insulin LY2605541 Versus Insulin Glargine

Diabetes Care ◽  
2013 ◽  
Vol 37 (3) ◽  
pp. 659-665 ◽  
Author(s):  
Richard M. Bergenstal ◽  
Julio Rosenstock ◽  
Edward J. Bastyr ◽  
Melvin J. Prince ◽  
Yongming Qu ◽  
...  
Keyword(s):  
Insulin Glargine ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Glucose Variability ◽  
Acting Insulin ◽  
Lower Glucose ◽  
Long Acting

scholarly journals Patterns of Interrelationships between Inflation, R&D, Innovation, and Economic Growth: Evidence from Central and Eastern European Countries

2020 ◽  
Vol 22 (2) ◽  
pp. 5-33
Author(s):  
Ljubivoje Radonjić ◽  
◽  
Nevena Veselinović ◽  
Keyword(s):  
Economic Growth ◽  
Positive Impact ◽  
Primary Objective ◽  
Output Growth ◽  
European Countries ◽  
Eastern European ◽  
Innovation Activities ◽  
Private And Public ◽  
Eastern European Countries ◽  
The Impact

The primary objective of the article is to examine the nexus between inflation, R&D, patents, and economic growth within a group of Central and Eastern European countries (CEECs). The examination is conducted in two parts. First, the impact of total R&D expenditures on economic growth is observed, as well as the influence of growth on private and public R&D investments. Second, the conversion from private and public R&D investment to innovation, measured by the number of patents, is observed. Throughout the analysis, economic growth and inflation are representative of macroeconomic stability. The outcomes of the panel auto-regressive distributed lag estimation indicate that total R&D expenditures are essential and positively significant for economic growth in the observed countries. The results also show that output growth has a remarkably positive impact on generating private R&D expenditures. Such an influence is also found, but at a weaker level, in the case of public R&D expenditures. In this part of the analysis, inflation has demonstrated a harmful influence on R&D expenditures. The results of the second part indicate that public and private R&D expenditures, at a significant level, generate innovation activities, while the impact of inflation has proven to be unimportant.

scholarly journals Mining, Poverty, and Income Inequality in Central and Eastern European Countries: What Do the Data Tell Us?

2021 ◽  
Vol 24 (3) ◽  
pp. 7-25
Author(s):  
Kunofiwa Tsaurai
Keyword(s):  
Income Inequality ◽  
Random Effects ◽  
Poverty Reduction ◽  
Common Ground ◽  
European Countries ◽  
Estimation Methods ◽  
Eastern European ◽  
Infrastructural Development ◽  
Eastern European Countries ◽  
The Impact

The study investigates the effect of mining on both poverty and income inequality in Central and Eastern European countries (CEECs) using econometric estimation methods with panel data spanning from 2009 to 2019. Another objective of this paper was to determine if the complementarity between mining and infrastructural development reduced poverty and or income inequality in CEECs. What triggered the study is the failure of the existing literature to have a common ground regarding the impact of mining on poverty and or income inequality. The existing literature on the subject matter is contradictory, mixed, and divergent; hence, it paves the way for further empirical tests. The study confirmed that the vicious cycle of poverty is relevant in CEECs. According to the dynamic generalized methods of moments (GMM), mining had a significant poverty reduction influence in CEECs. The dynamic GMM and random effects revealed that the complementarity between mining and infrastructural development also enhanced poverty reduction in CEECs. Random effects and pooled OLS shows that mining significantly reduced income inequality in CEECs. However, random effects and the dynamic GMM results indicate that income inequality was significantly reduced by the complementarity between mining and infrastructural development. The authorities in CEECs are therefore urged to implement mining growth and infrastructural development-oriented policies in order to successfully fight off the twin challenges of poverty and income inequality.

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