OBJECTIVES : Insulin is an essential and life-saving medicine for all type 1 diabetes mellitus patients and some type 2 diabetes mellitus patients who have severe complications. But the high price and low availability make it inaccessible to patients who are in absolute need for insulin. To facilitate access to affordable insulin products, we conducted a cross-sectional survey on price and availability of insulin in Shaanxi Province.

METHODS : We used a simplified and adapted World Health Organization/Health Action International methodology to obtain the availability and price of insulin products and 5 oral anti-diabetic medicines as comparators in public general hospitals and private retail outlets. Besides, we investigate the price components of several selected insulin products tracing along the supply chain.

RESULTS : All three kinds of Insulin products, prandial, basal and premixed insulin, have a 100% availability in public hospitals, and have a fairly high availability in private sector ranging from 62.5% to 68.8%. Most insulin products had higher price compared with international reference price in both sectors (ranging from 0.95 times to 2.33 times). All insulin products were unaffordable which would cost 3.5 to 17.1 days’ wage of lowest-paid government worker in Shaanxi. Manufacturer selling price, making up a proportion more than 60% in final price of all insulin products surveyed, was the largest component.

CONCLUSIONS : Although availability of insulin products was high in public general hospitals and private retail pharmacies, high price made them unaffordable to diabetes patients, especially low-income patients. Government should try to increase insurance compensation for those who need these life-saving medicines, or try to decrease price of insulin products through negotiation with suppliers.