Table 4

Medication costs, per patient per year

Country/studySettingDiabetes typeCost per medication, per patient, per year (2016 US$)
Insulin*NPH insulinAnalogue insulinOral medications†GlibenclamideMetforminCVD medications‡Antidiabetic§
Data reported by patients
Lower middle-income countries
Solomon Islands35 SC218.8327.2012.55
Data from provider/system perspective
Low-income countries
Malawi15 Supply1450.00
Central African Republic15 Supply1335.16
Somalia15 Supply1180.00
Burkina Faso15 Supply1180.00
Nepal15 Supply1135.00
Benin15 Supply1144.00
Lower middle-income countries
Cambodia57 Supply2117.7225.603.0925.76
Mauritania15 Supply1140.22
Cambodia15 Supply1180.00
Pakistan15 Supply14.98
Mongolia15 Supply10.00¶
Cote d’Ivoire15 Supply191.80
India15 Supply1103.50
India58 SC2439.83
Upper middle-income countries
Iran59 SC-Public279.2895.71
Private281.4157.83
Iran60 SC263.24236.04
Jordan61 SCDM91.82**
391.08††
Jordan62 SC2393.78952.69
Serbia63 Unclear256.4335.13
Ecuador15 Supply1109.80
Bulgaria64 SC1481.89
St Lucia15 Supply10.00¶
China65 SCDM494.44466.38
Brazil48 SC1384.5930.88
Brazil66 SC249.937.6812.8021.7770.42
Data from both patient and provider perspectives
Lower middle-income countries
Vietnam67 Missing1 and 290.87378.44
Philippines67 Missing1 and 2242.19165.17
Upper middle-income countries
China68 SC2270.31
China69 SC2257.72
Mexico46 PC25.1612.02
Brazil55 SC2278.47124.38
Argentina70 Public2518.691555.24‡‡
1036.83‡‡
945.59§§
250.50
  • Some studies also included other medicines: antibiotics35; pain relief/anti-inflammatory drugs35; gliflozin class drugs68; sulfonylureas68 69; metformin combinations (with glibenclamide,46 with DPP4i).70 An additional study included medication costs per complication without breaking this out by specific medication.45

  • *Indicated as (non-specific) insulin in study text.

  • †Indicated as group of oral antidiabetic medications (non-specified per drug) in study text (excluding medicines for comorbidities such as CVD); any specifications included as footnotes here.

  • ‡Includes lipid-lowering medicines, antiplatelet, antihypertensive drugs. All antidiabetic medications summed together (ie, the cost of insulin plus oral antidiabetic medications).

  • §Insulin provided free of charge to surveyed health facilities in this country.

  • ¶Insulin vials.

  • **Insulin cartridges.

  • ††Levemir.

  • ‡‡Insulin lispro.

  • CVD, cardiovascular disease; DM, diabetes mellitus; NPH, neutral protamine Hagedorn; PC, primary care; SP, specialised care.