This report examines insulin production, supply, and pricing across low- and middle-income countries (LMICs). It finds that a small number of multinational manufacturers dominate insulin supply, though local and biosimilar producers play a growing role in some markets. Despite limited competition in many countries, insulin prices remain relatively low compared to high-income markets, with wide variation across regions. The report finds no clear correlation between market concentration and insulin costs. It emphasizes the importance of supply reliability, regulatory capacity, and procurement practices in improving access to insulin for patients in LMICs.

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