A demand for an insulin price cap from doctors in Kolkata has exposed a wider problem in chronic healthcare: access is not secured merely because a medicine is available. For people who need insulin every day, the cost, format and continuity of supply can determine whether treatment continues at all. The doctors’ call for a zero-cost insulin care package therefore goes beyond a pricing request. It raises questions about whether India’s healthcare system treats essential medicines as a one-time purchase or as a continuing public responsibility.
The demand was made at a talk at the Calcutta International Club, where diabetologist Debasis Basu called for “a zero-cost insulin care package for every person with clinical need for insulin”. Basu, who chairs the Metta Dana Foundation and has supported patients requiring insulin, framed the issue in direct terms: “No one should die for want of insulin.” The statement links affordability to survival rather than convenience, particularly for patients who cannot interrupt treatment without risking serious health consequences.
The evidence in the report also shows why a headline price can conceal the real burden on households. Paediatrician Apurba Ghosh, executive director of the Institute of Child Health, said insulin prices range from Rs 2.5 to Rs 6 per unit. He added that vials cost less than pens, but patients may prefer pens because injections are less painful. This distinction matters for children who must take insulin every day. A cheaper option is not automatically an equivalent option when pain, ease of administration and the ability of a child or caregiver to maintain treatment are part of the decision.
The doctors’ comments point to a form of healthcare expenditure that is repeated, predictable and difficult to avoid. A patient requiring insulin does not face a single medical bill; the expense recurs with every dose. KK Gangopadhyay, a senior endocrinologist with Peerless Hospital, said the price of insulin had reduced because doctors had advocated price cuts in meetings with government and policymakers. He placed the price of a unit between 50 paise and Rs 3 and said Indian patients roughly require 20 to 30 units a day.
Even using that broad range, the daily requirement described by Gangopadhyay translates into a continuing expense rather than an isolated purchase. At 20 to 30 units a day, a difference of even a small amount per unit accumulates across every day of treatment. The report does not provide a complete monthly cost for different insulin brands, delivery devices or patient groups, so the exact household burden cannot be calculated from the available evidence. But the basic cost structure is clear: when treatment is daily, affordability must be assessed over time.
The gap between vials and pens also shows why price regulation cannot be considered only at the level of the medicine itself. A policy that lowers the cost of insulin but leaves patients unable to access a usable delivery format may not fully address adherence. Ghosh’s comments indicate that the choice of pen can be connected to pain and the needs of children. The report does not establish how many patients use pens, how much more they cost in different markets or whether any existing public programme subsidises them. Those unanswered questions would be central to designing a meaningful care package.
The most serious consequence described by the doctors is treatment interruption. Arunansu Talukdar, head of geriatric medicine at Medical College and Hospital, said some patients stopped taking insulin after a few weeks because they could no longer afford it regularly. This is a critical distinction between nominal access and effective access. A drug may be present in pharmacies and hospitals, yet remain functionally unavailable if patients cannot keep purchasing it for as long as the treatment requires.
For urban healthcare systems, this shifts attention from the point of prescription to the full chain of care. The patient must be diagnosed, prescribed insulin, obtain it repeatedly, store and administer it, and continue doing so despite changes in income or household expenses. The report specifically connects the issue to children’s education and family budgets, while Talukdar’s observation identifies older patients who discontinue treatment. The affected groups may differ, but the underlying pressure is similar: essential care competes with other unavoidable household needs.
The doctors’ proposal for a zero-cost insulin care package appears to respond to this continuity problem. The available report does not define the package’s proposed funding mechanism, delivery agency, eligibility criteria or relationship with existing government schemes. It is therefore not possible to say whether the proposal is intended to be implemented through public hospitals, insurance, direct benefit transfers, subsidised pharmacy channels or another model. What is clear is that the demand seeks to move the discussion from reducing prices to guaranteeing treatment for people with a clinical need.
That distinction is important for public administration. A price cap would address the amount charged for insulin, but a zero-cost package would require decisions about who qualifies, which formulations and delivery devices are covered, how supplies are procured, and how uninterrupted distribution is monitored. It would also require coordination between clinicians, hospitals, pharmacies and policymakers. The comments reported from Kolkata doctors establish the demand and its public-health rationale, but they do not establish whether authorities have accepted it or announced an implementation plan.
The reported price figures also show why the issue requires careful interpretation. Basu cited a range of Rs 2.5 to Rs 6 per unit, while Gangopadhyay cited a range of 50 paise to Rs 3 per unit. These figures may reflect differences in product, formulation, delivery method or market context, but the supplied report does not explain the reason for the variation. The difference should not be treated as a contradiction without further documentation. It does, however, underline the need for transparent information on how insulin prices are calculated and how patients experience those prices at the point of purchase.
The report provides no data on the number of patients affected in Kolkata, the scale of insulin shortages, the frequency of treatment discontinuation or the share of household income spent on insulin. It also does not identify a specific government response. Those limitations matter because a policy case requires more than individual price examples. Authorities would need reliable information on patient numbers, prescription patterns, product availability, pen and vial use, and the locations where supply breaks down. Without such data, a cap could be difficult to monitor and a free-care package difficult to target and sustain.
Yet the absence of those figures does not make the problem marginal. The doctors’ accounts identify a direct connection between cost and treatment continuity. In a city, that connection can be intensified by uneven access to hospitals, travel costs, lost work time and the need for caregivers, although the supplied report does not quantify those additional burdens. The central fact supported by the report is narrower and more significant: some patients are reportedly stopping insulin because regular treatment has become unaffordable.
This makes insulin affordability an urban governance issue as well as a clinical one. Cities are where hospitals, pharmacies, public health institutions and vulnerable households meet, but the availability of services does not guarantee equal access. If patients cannot maintain treatment, the system’s performance cannot be judged only by the number of consultations or the availability of medicines on a particular day. Continuity, affordability and suitability of delivery are equally relevant to whether care works in practice.
The Kolkata discussion also reveals a policy tension. Doctors say earlier advocacy contributed to lower insulin prices, suggesting that public and professional pressure can influence affordability. At the same time, the continued reports of patients stopping treatment indicate that lower prices have not eliminated the access problem. The evidence does not show whether further price reductions alone would solve it. It does show why the debate is moving towards a broader guarantee that covers the recurring needs of people dependent on insulin.
The next stage of this debate will depend on what is formally proposed and whether authorities respond. Key questions include whether a price cap is being sought for all insulin products or particular formulations, whether pens would be included, how children and older patients would be covered, and whether the proposed zero-cost package would guarantee regular supply. The available report records the doctors’ demand and the patient impact they described, but not an official decision.
What the evidence confirms is that insulin affordability is not simply a question of the price printed at the pharmacy. It is a test of whether a city’s healthcare system can support treatment that must continue every day. Kolkata doctors have placed that test before policymakers through their call for a price cap and zero-cost care package. The unresolved issue is whether the demand will become a defined, funded and reliably delivered public-health measure.
