BACKGROUND: Diabetes mellitus rates and associated costs continue to rise across Europe enhancing health authority focus on its management. The risk of complications is enhanced by poor glycaemic control, with long-acting insulin analogues developed to reduce hypoglycaemia and improve patient convenience. There are concerns though with their considerably higher costs, but moderated by reductions in complications and associated costs. Biosimilars can help further reduce costs. However, to date, price reductions for biosimilar insulin glargine appear limited. In addition, the originator company has switched promotional efforts to more concentrated patented formulations to reduce the impact of biosimilars. There are also concerns with different devices between the manufacturers. As a result, there is a need to assess current utilisation rates for insulins, especially long-acting insulin analogues and biosimilars, and the rationale for patterns seen, among multiple European countries to provide future direction. Methodology. Health authority databases are examined to assess utilisation and expenditure patterns for insulins, including biosimilar insulin glargine. Explanations for patterns seen were provided by senior-level personnel. RESULTS: Typically increasing use of long-acting insulin analogues across Europe including both Western and Central and Eastern European countries reflects perceived patient benefits despite higher prices. However, activities by the originator company to switch patients to more concentrated insulin glargine coupled with lowering prices towards biosimilars have limited biosimilar uptake, with biosimilars not currently launched in a minority of European countries. A number of activities were identified to address this. Enhancing the attractiveness of the biosimilar insulin market is essential to encourage other biosimilar manufacturers to enter the market as more long-acting insulin analogues lose their patents to benefit all key stakeholder groups. CONCLUSIONS: There are concerns with the availability and use of insulin glargine biosimilars among European countries despite lower costs. This can be addressed.

Agency for Medicinal Product and Medical Devices of Bosnia and Herzegovina 78000 Banja Luka Bosnia and Herzegovina

Centre for Primary Care and Health Services Research School of Health Sciences University of Manchester Manchester M13 9PL UK

Chair of Epidemiology and Preventive Medicine Medical College Jagiellonian University Krakow Poland

Dachverband der Österreichischen Sozialversicherungen Kundmanngasse 21 AT 1030 Vienna Austria

Department of Global Health Economics and Policy University of Kragujevac Kragujevac Serbia

Department of Global Public Health Karolinska Institutet Stockholm Sweden

Department of Health Policy and Health Economics Eotvos Lorand University Budapest Hungary

Department of Health Services Management University of Malta Valletta Malta

Department of Medical Biophysics Faculty of Medicine in Hradec Králové Charles University Simkova 870 500 03 Hradec Králové Czech Republic

Department of Pathology Forensic Medicine and Pharmacology Institute of Biomedical Sciences Faculty of Medicine Vilnius University Vilnius Lithuania

Department of Pharmacology College of Pharmacy Hawler Medical University Erbil Iraq

Department of Pharmacology Therapeutics and Toxicology Universitat Autònoma de Barcelona Barcelona Spain

Department of Pharmacy Disciplinary Domain of Medicine and Pharmacy Uppsala University Uppsala Sweden

Department of Pharmacy Faculty of Medicine University of Medicine Tirana Albania

Department of Pharmacy Practice and Policy Faculty of Health Sciences University of Namibia Windhoek Namibia

Division of Public Health Pharmacy and Management School of Pharmacy Sefako Makgatho Health Sciences University Pretoria South Africa

Drug Department Catalan Health Service Gran Via de les Corts Catalanes 08007 Barcelona Spain

Faculty of Medicine Department of Medicinal Chemistry University of Banja Luka Banja Luka Bosnia and Herzegovina

Faculty of Medicine Department of Social Pharmacy University of Banja Luka Banja Luka Bosnia and Herzegovina

Faculty of Medicine Public Health and Management Department Carol Davila University of Medicine and Pharmacy Bucharest 050463 Bucharest Romania

Faculty of Pharmacy Department of Social Pharmacy and Pharmacoeconomics Medical University of Sofia Sofia Bulgaria

Faculty of Pharmacy UBT Higher Education Institute Pristina Kosovo

Health Insurance Institute Miklosiceva 24 SI 1507 Ljubljana Slovenia

HTA Consulting Starowiślna Str 17 3 31 038 Krakow Poland

Independent Consultant Riga Latvia

Institute of Comparative Economic Studies Faculty of Economics Hosei University Tokyo Tokyo Japan

Istituto di Ricerche Farmacologiche 'Mario Negri' IRCCS Milan Italy

Medicines Committee Oslo University Hospitals Oslo Norway

National Organization for the Provision of Healthcare Services Athens Greece

NEPI Nätverk för läkemedelsepidemiologi Stockholm Sweden

NHS Lothian Edinburgh UK

NIHR Greater Manchester Patient Safety Translational Research Centre School of Health Sciences University of Manchester Manchester UK

Pharmacy Services Greater Glasgow and Clyde Glasgow UK

Public Health Scotland Gyle Square 1 South Gyle Crescent Edinburgh UK

School of Pharmaceutical Sciences Universiti Sains Malaysia Penang Malaysia

State Agency of Medicines Nooruse 1 50411 Tartu Estonia

State Institute for Drug Control Prague Czech Republic

Strathclyde Institute of Pharmacy and Biomedical Sciences University of Strathclyde Glasgow G4 0RE UK

Syreon Research Institute and Semmelweis University Center of Health Technology Assessment Budapest Hungary

Wissenschaftliches Institut der AOK Rosenthaler Straße 31 10178 Berlin Germany

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Biomed Res Int. 2023 Apr 7;2023:9757348. doi: 10.1155/2023/9757348. PubMed

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Corrigendum to "Utilisation Trend of Long-Acting Insulin Analogues including Biosimilars across Europe: Findings and Implications"