Biosimilar insulin glargine: a solution for affordable and equitable diabetes care

Abstract

Over past decades, insulin therapy has been a cornerstone in reshaping diabetes care from a chronically morbid disease into a manageable condition. Despite availability of multiple pharmacological therapies, diabetes patients still suffer from optimum glycaemic control especially fasting hyperglycaemia which further increase the risk of developing vascular complications. Basal insulin is a choice of medication when patients require fasting blood glucose control to achieve desired glycaemic goal. With such crucial need of basal insulin therapy for controlling fasting hyperglycaemia, it remains inaccessible for majority of patients in need. This challenge is more prevalent in low- and middle-income countries where need for insulin is rising as prevalence of diabetes increases. Biosimilar insulin has arisen as an important strategy to bridge this gap. This review addresses the outline of evolution of basal insulin therapy, especially biosimilar insulin glargine as a solution to overcome fasting hyperglycaemia. One such illustration is of biosimilar insulin glargine (BASALOG®, BIOCON) for which evidence from global clinical trials and real-world studies has demonstrated its safety, efficacy and immunogenicity comparable to the reference insulin glargine available. This has further led to the approval for biosimilar insulin glargine overseas including interchangeability designation by USFDA. Further this review underlines the Indian perspective regarding biosimilar insulin glargine affordability and adoption with emphasis on patient education, cold-chain management to increase access and real-world data generation. Collectively, biosimilar insulin glargine offers a scalable and sustainable model which has potential to expand access of basal insulin therapy to patients who are in need.