Faculty of Pharmacy, Universitas Pancasila, South Jakarta, Indonesia.
Health Action International, Amsterdam, The Netherlands.
PLoS One. 2024 Oct 3;19(10):e0309350. doi: 10.1371/journal.pone.0309350. eCollection 2024.
Insulin is essential for the survival of people with type 1 diabetes and for better management of people with type 2 diabetes. People with diabetes using insulin also require self-monitoring blood glucose (SMBG) devices (e.g., meters, strips, continuous monitoring systems) for day-to-day management. It is essential to ensure that insulin and these devices are available and affordable. This study aimed to evaluate the availability, price, and affordability of insulin and SMBG devices in Indonesia using an adaptation of the World Health Organization/Health Action International (WHO/HAI) price survey. A total of 34 public health facilities (hospitals, primary healthcare centres/Puskesmas) and 37 private pharmacies were sampled. Information from three major online marketplaces was also collected. Prices were expressed as median patient prices (US$). Affordability was defined as the number of days' wages needed by the lowest paid unskilled government worker (LPGW) to purchase 30 days' supply of insulin, delivery devices and SMBGs. Availability of analogue insulin was slightly higher in public facilities (63.6%) than in the private sector (43.2%), with no human insulin available in both sectors. Conversely, better availability was observed in private facilities for SMBG devices as public sector facilities did not supply devices for self-testing. Median prices for 1000IU analogues varied between the public sector (US$ 5.26) and the private sector (US$11.24). The highest median price of analogues was seen in online marketplaces (US$ 28.65). The least costly median price of SMBG devices were observed in online platforms (meter: US$ 18.37, test strip: US$ 0.27, lancet: US$ 0.02). A low-income person had to work 2-3 days to buy 1000IU of analogues. It required 5-7 days' and 4-5 day's wages to purchase a meter and a month's supply of test strips, respectively. The availability and affordability of insulin and SMBG devices remain important issues in Indonesia requiring holistic approaches for further improvement.
胰岛素对于 1 型糖尿病患者的生存和 2 型糖尿病患者的更好管理至关重要。使用胰岛素的糖尿病患者还需要自我监测血糖 (SMBG) 设备（例如血糖仪、试纸、连续监测系统）进行日常管理。确保胰岛素和这些设备的可用性和可负担性至关重要。本研究旨在使用世界卫生组织/国际健康行动组织 (WHO/HAI) 价格调查的改编版评估印度尼西亚胰岛素和 SMBG 设备的可及性、价格和可负担性。总共抽取了 34 家公共卫生机构（医院、初级保健中心/乡级卫生所）和 37 家私人药店，并收集了三个主要在线市场的信息。价格以患者价格中位数（美元）表示。可负担性定义为最低工资非熟练工人（LPGW）购买 30 天胰岛素、配送设备和 SMBG 所需的工资天数。公共设施中类似物胰岛素的可及性略高于私营部门（63.6%比 43.2%），两个部门均无人类胰岛素。相反，私人设施中 SMBG 设备的可及性更好，因为公共部门设施不提供自我测试设备。1000IU 类似物的中位数价格在公共部门（5.26 美元）和私营部门（11.24 美元）之间有所不同。在线市场上观察到类似物的最高中位数价格（28.65 美元）。SMBG 设备最便宜的中位数价格出现在在线平台上（血糖仪：18.37 美元，测试条：0.27 美元，采血针：0.02 美元）。一个低收入者必须工作 2-3 天才能购买 1000IU 的类似物。购买血糖仪和一个月的测试条分别需要 5-7 天和 4-5 天的工资。胰岛素和 SMBG 设备的可及性和可负担性仍然是印度尼西亚的重要问题，需要采取整体方法进一步改善。
