A Call for Improved Global Access to Insulin

Insulin pens
Insulin pens
Three major manufacturers currently dominate the global insulin market.

Three major suppliers worldwide continue to dominate the global insulin market, despite the increasing prevalence of diabetes around the world, according to a study presented at the World Diabetes Congress. As these numbers grow, it is paramount that insulin suppliers are able to keep pace with the growing demand, the investigators noted.

The International Diabetes Federation (IDF) recently released its Diabetes Atlas, which estimates that 415 million people in the world currently have diabetes. A major concern at this time is the problem of equitable access to affordable insulin, especially in low- and middle-income countries.

Although there are many insulin manufacturers, the global market is dominated by 3 companies — Novo Nordisk, Sanofi, and Eli Lilly — that are the sole insulin providers in many countries.

“This is the first study of its kind that we know of. Market research companies look at the insulin market, but this study is more comprehensive, has a focus on access, and looks more at the locations of product registry and sales,” lead study investigator Ryan Knox, of the Boston University School of Public Health, said.

An understanding of the global insulin market is essential for identifying and developing pharmaceutical policies that ensure universal access to insulin to those who require it, according to Knox.

This new study identified insulin manufacturers and their locations of product registry and/or sales. The investigators examined country markets and identified opportunities for improving access to insulin.

“Endocrinologists should care about this type of study because the problem of access to insulin, particularly the affordability of insulin, has the potential to affect a patient’s adherence to insulin, and thus their overall quality of life and their diabetes outcomes,” Knox told Endocrinology Advisor. “The overall goal of this study is to develop policies that will improve access to insulin, and thus improve adherence and diabetes outcomes.”

Knox and his team performed a literature review of the global insulin market, consulted Business Monitor International Pharmaceuticals & Healthcare Industry Reports, and analyzed data provided by IMS Health, which collects data on the healthcare industry. Websites of drug regulatory authorities and pharmaceutical manufacturers were also included.

After creating a list of potential insulin manufacturers and their locations of product registry and/or sales, the investigators were able to identify regions of opportunity and analyze the local markets of the 6 low- and middle-income countries with the largest populations of people with diabetes (China, India, Brazil, Mexico, Indonesia, and Egypt).

In addition to the 3 major pharmaceutical companies, there were 39 potential insulin manufacturers and 62 distributors and licensed manufacturers, according to the data.

The 3 major companies have products registered and/or sold in more than 90 countries, and were the sole insulin providers in 55% of the 121 countries studied by Knox and colleagues.

Following the major companies, the investigators found there were 4 smaller companies (Bioton, Wockhardt, Biocon, and Julphar) with products registered and/or sold in 10 to 30 countries. 

“My co-investigators and I were surprised by these findings. First, we were surprised at how many other potential insulin manufacturers were identified. Second, we were surprised at how many manufacturers were headquartered in and selling their products in emerging markets,” said Knox. 

“The problem of access to insulin is not a new problem, but seems to have been growing. More importantly, the opportunities for increased competition, with more insulin analogs coming off patent and more insulin manufacturers growing in market strength and capacity, are relatively new and more promising.”


  1. Knox R, Kaplan W, Wirtz V. The global insulin market: Opportunities and challenges to promote equitable access to affordable insulin. Presented at the World Diabetes Congress; November 30-December 4, 2015; Vancouver, Canada.