The introduction of biosimilar insulin glargine has triggered significant price reductions across European markets, according to a comprehensive study published in BMJ Open. The research, spanning 28 European countries over a decade (2013-2023), demonstrates how increased competition from biosimilars can effectively drive down insulin prices and potentially improve patient access to essential diabetes treatment.
Market Impact and Price Dynamics
The study revealed a substantial 21.6% average decrease in originator insulin prices across all surveyed countries during the 10-year observation period (P < .001). Markets with one biosimilar competitor experienced a 22.2% price reduction, while those with two biosimilars saw a 21% decrease (P < .001).
Statistical analysis demonstrated that biosimilar market entry resulted in an immediate average price reduction of 0.842 units (P < .001), followed by sustained quarterly decreases of 0.054 units (P < .001). This trend suggests a lasting impact of biosimilar competition on market pricing dynamics.
Regional Price Variations
The research uncovered significant price disparities across European markets. Lantus, the originator product, showed prices ranging from €7.7 in Poland to €15.6 in Switzerland. Similar variations were observed for biosimilars, with Abasaglar prices spanning from €6.1 in Poland to €13.1 in Switzerland, and Semglee ranging from €6.0 in Slovakia to €10.8 in Spain.
By 2022, median prices settled at:
- Originator insulin: €9.0 (IQR, €8.35-€10.73)
- Abasaglar biosimilar: €8.9 (IQR, €7.84-€10.42)
- Semglee biosimilar: €7.0 (IQR, €7.01-€7.73)
Market Context and Global Implications
The findings are particularly significant given the current state of the global insulin market, valued at $36 billion in 2020. Three major pharmaceutical companies - Novo Nordisk, Eli Lilly, and Sanofi - dominate the market, controlling 99% by value and 96% by volume. This market concentration has historically contributed to maintaining high insulin prices.
Biosimilar Market Penetration
The study highlights that insulin glargine biosimilars typically achieve a 26% market share within five years of launch. However, market uptake has been influenced by various factors, including Sanofi's dual pricing strategy for Lantus, which has helped maintain its market leadership position despite biosimilar competition.
Policy Implications
While most countries demonstrated significant price reductions following biosimilar entry, some markets, notably Switzerland and Denmark, experienced initial price increases. These variations underscore the influence of different regulatory environments and pricing mechanisms across countries.
The researchers emphasize that future insulin affordability will depend heavily on policy-makers and national authorities creating transparent markets with healthy competition, effective price negotiations, and improved education for healthcare providers and patients.
