Local insulin production in Pakistan

The country with the 5th largest population will have over 60 million people living with diabetes by 2045.

Rising inflation rates in Pakistan have made it difficult for insulin manufacturers to import insulin and market them at the prices capped by the country’s drug regulatory authority. This has led to three critical shortages of insulin in the past year, impacting people with both type 1 and type 2 diabetes. While the essential insulin prices in Pakistan continue to be low as compared to most other countries, the economic conditions for people, businesses, as well the government, negatively impacts accessibility, affordability and availability of the lifesaving hormone.

In response to this urgent issue a roundtable discussion was organized in March, with support of Meethi Zindagi and T1International, in line with the Global Day of Action for insulin4all, involving regulatory authorities and policy makers as well as civil society, health professionals and industry representatives. A central theme of the discussion was the regulation required to support local production, as well as encouraging the big three insulin manufacturers to set up strategic productions sites in the region to reduce production and logistic costs.

Several middle-income countries such as India, Malaysia, and Bangladesh, have successfully established insulin production facilities, while similar efforts are ongoing in Africa. A shift towards local production is poised to allow them to meet some of the insulin needs domestically. Beyond traditional insulin production, biosimilar insulin, approved by both the World Health Organisation (WHO) and the US Federal Food and Drug Administration (FDA), offers another promising avenue. A significant advantage of biosimilar insulin is its affordability – it costs roughly one-quarter the amount to set up production compared to regular insulin making it highly suitable for low and middle income countries.

With focused efforts by policy makers, countries could potentially achieve self-sufficiency in insulin production and possibly even export it in the region. The roundtable in Pakistan and subsequent advocacy efforts have captured the interest of the local pharma industry and policy makers alike and quick action for diversifying import pathways and local production is under progress.

Advocacy Action: What policies and plans does your country have in place for ensuring that people with diabetes are not affected possible insulin shortages? Can you ask your representatives to discuss short, medium and long term plans to ensure life saving insulins will be guaranteed to avoid the shortages that are affecting the global community.