Insulin availability among International Diabetes Federation member associations. Report of the Task Force on Insulin Distribution.

OBJECTIVE

To assess the availability of insulin and diabetes supplies among International Diabetes Federation (IDF) member associations.

RESEARCH DESIGN AND METHODS

A mail survey of IDF member associations asked about the following issues: 1) diabetes prevalence and insulin use, 2) availability and cost of insulin and supplies, 3) availability of glycemic monitoring supplies, 4) cost of insulin and supplies to patients, and 5) availability of oral hypoglycemic agents.

RESULTS

Of 85 member associations, 60 responded. The mean prevalence of diabetes was 3.7%. Of the 39 with a population-based survey data, the prevalence was 3.9%. Insulin use was reported for 19.2% of diabetes patients and, for the 15 with population-based data, the proportion using insulin was 16.1%. Of the respondents, 47 (78%) reported insulin was always available, 11 (18%) reported insulin was available from 25 to 99% of the time, and 2 (Uganda and Tanzania) reported insulin was available < 25% of the time. Insulin is free to patients in 39 (65%) of the countries. The average cost of the least expensive insulin was U.S. $9.62 per vial. Fifteen countries imposed a mean 13% customs charge. Disposable syringes were available in 42 (72%) of countries all of the time. Glucose meters were in use in 49 countries. The most common oral agent was glyburide, which was available in 57 countries.

CONCLUSIONS

Insulin is in reasonable supply in IDF member countries. Cost and customs charges are an impediment to universal access. IDF now can recommend programs based on this data.