The year 2021 marked the centenary of the discovery of insulin. Considered one of the greatest medical achievements, insulin has saved millions of lives, but access remains a challenge, especially in low- and middle-income countries. The barriers to accessing insulin are diverse and often context-specific, but low competition in the supply and production of insulin and high prices are key limitations.

This working paper proposes a competition law approach as one means for examining the challenge of promoting access to insulin. This is an area of policy and practice that could prove useful, although often underutilized, in efforts to promote access to health technologies. 

This paper is published with the aim of soliciting comments and feedback from a broad range of stakeholders, and to stimulate further discussion and analysis.  It is important to note that it is not an attempt at drawing conclusions with respect to anti-competitive behaviours; rather, the goal is to provide practical guidance on the potential utility of competition law as a strategy to increase access to insulin. 

The working paper follows from previous work in this area. In 2015, UNDP published ‘Using Competition Law to Promote Access and Health Technologies: A guidebook for low- and middle-income countries’. More recently in 2022, UNDP published a supplement, which updates the 2014 guidebook. Both publications are intended as guidance to competition and public health authorities in low- and middle-income countries on the use of competition law to promote access to health technologies.