Over the past decades, there have been continuous strides forward in diabetes treatment and management. Consequently, clinical guidelines have been updated to reflect the latest scientific evidence. Despite this, for a large proportion of people with diabetes (PwD), the disease remains uncontrolled.

Together with PwC, the EFPIA Diabetes Platform has developed a report to explore the reasons behind variability in management of diabetes in different Member States, focusing on how policies at the national and local levels are creating barriers to more consistent, effective and equitable treatment of diabetes and improved health outcomes for all people living in Europe. These barriers include:

• Guideline-related policies: how local and national policies can impair the ability to adapt and adhere to the best clinical standards as per international guidelines
• Access-related policies: reimbursement delays and restrictions; prescription limitations and affordability concerns
• Process-related policies: bureaucratic pathways, prescription processes and quotas, and limited HCP time and knowledge.

Taken together, these barriers can create ‘therapeutic inertia’ which means people with diabetes do not always receive the treatment they need when they need it. For example, evidence shows that in some EU countries less than 10% of medical professionals initiate PwD on insulin at the recommended time. That leads to worsening health outcomes and rising healthcare costs.  

More can be done to improve outcomes and contribute to health systems and societal resilience and sustainability. This report makes some clear proposals about what can be done to overcome barriers and ensure that all people with diabetes can receive the best possible treatments to improve their health and quality of life:

1. Review and optimise any complex processes that may impair doctors’ ability to prescribe the best therapy for each patient, as well as the PwD ability to fill their prescriptions.
2. Regularly review guideline updates and the ever-growing body of health economic data concerning therapeutic approaches to T2D to make sure that existing resources are allocated as efficiently as possible, and the value delivered to PwD is maximised.
3. Update existing access and reimbursement policies to enable early therapy intensification (versus step approach) in diabetes management – as recommended by the most recent international guidelines.
4. Review eligibility criteria for non-insulin antidiabetics, in particular by making sure that other risk factors, in addition to uncontrolled glycaemia, are considered to initiate prescription - as recommended by the most recent international guidelines.

We look forward to continuing the conversation on how to improve outcomes for people living with diabetes at our event on 24 May.