OBJECTIVES: The price of insulin has increased steadily in the US, threatening the affordability of this essential drug. The objectives of this study were to compare pharmacy insulin prices as of January 1, 2020, in Canada, Saudi Arabia, and the US.

METHODS: Data on insulin products marketed in the US was derived from the FDA databases and pharmacy prices from the RedBook and GoodRx. Prices for insulins marketed in Saudi Arabia were extracted from the SFDA drug database, and for Canada, data was extracted from Canadian Insulin. Insulin products available in the 3 markets were included in the analysis. All prices were indexed to Canada = 100. Descriptive statistics were used for the analysis.

RESULTS: We identified 5 insulin brand products marketed in the 3 countries. The indexed price for insulin glulisine 100 units/ml vial was 42.2 in Saudi Arabia, 100.0 in Canada, and 548.4 in the US; insulin lispro 100 units/ml pen was 49.6 in Saudi Arabia, 100.0 in Canada, and 697.0 in the US; insulin Glargine 100 units/ml pen was 41.6 in Saudi Arabia, 100.0 in Canada, and 224.8 in the US; insulin detemir 100 units/ml pen was 35.0 in Saudi Arabia, 100.0 in Canada, and 263.5 in the US; Insulin degludec 100 units/ml pen was 63.8 in Saudi Arabia, 100.0 in Canada, and 380.6 in the US; insulin degludec 200 units/ml pen was 64.7 in Saudi Arabia, 100.0 in Canada, and 385.1 in the US. Overall, insulin prices were lower in Saudi Arabia (average±standard deviation+ 49.5±12.3, median= 45.9), than in Canada (average and median= 100), and the US (416.6±178.0, median=382.9).

CONCLUSION: Prices of insulin products on January 1, 2020, were over 4 times higher in the US than in Canada, and over 8 times higher in the US than in Saudi Arabia.