Availability, price and affordability of insulin, delivery devices and self-monitoring blood glucose devices in Indonesia

Hesty Utami Ramadaniati; Yusi Anggriani; Molly Lepeska; David Beran; Margaret Ewen

doi:10.1371/journal.pone.0309350

Peer Review History

Original SubmissionFebruary 21, 2024
12 Jun 2024 Decision Letter - Diana Laila Ramatillah, Editor PONE-D-24-04996Availability, price and affordability of insulin, delivery devices and self-monitoring blood glucose devices in IndonesiaPLOS ONE Dear Dr. Ramadaniati, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Please submit your revised manuscript by Jul 27 2024 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. 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(Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: This is a very interesting study with important findings. However, the study does not exactly follow WHO/HAI methodology while doing pricing calculations. This needs to be described clearly in the methods/discussion and limitations sections of the study. Kindly mention the following The study does not exactly follow a WHO/HAI methodology but a variation and the prices are reported in USD (instead of a median price ratio) This could be partly because of the absence of an updated international MSH drug pricing indicator guide (as the last one was published in 2015) Also at places, sentences and paragraphs need support references (for example below) Thirdly, the lack of a universally accepted definition of affordability may impede the accurate comparison of our findings with those of other studies. Reviewer #2: 1. Line 176: The authors have used 150 test strips. Is this for a month or the entire two years? If this is meant for a month, I would suggest to use the Indonesian guidelines. Indonesia, being a middle income country, it is less likely for a diabetic to do 6-8 self-assessment per day. 2. Line 203-204: “As human insulin was not available in public health facilities, it is unsurprising that no insulin syringe was provided in this sector.” I tend to defer with the authors as to the unavailability of insulin syringes in public facilities. This is because of certain types of analogue insuring requires syringes for administration. Please re-look at this. 3. Line 396-451. This section seems to be new and does not relate to the title and the flow of the rest of the document. If the authors need to include it, they need to either alter the title, or add another secondary objective of the study to match with the discussion ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). 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Revision 1
11 Jul 2024 Author Response PONE-D-24-04996 Availability, price and affordability of insulin, delivery devices and self-monitoring blood glucose devices in Indonesia Dear Academic Editor and Reviewers, We sincerely express our gratitude for your insightful and critical comments on our manuscript. We have modified the manuscript in response to your remarks. We do hope that the revised manuscript will be considered by PLOS ONE. We will respond to the comments point counter point. ----------------------------------------- Journal Requirements: 1. When submitting your revision, we need you to address these additional requirements. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. RESPONSE: we have prepared the revised version and its supporting documents, so they are in line with PLOS ONE’s style requirements. 2. We suggest you thoroughly copyedit your manuscript for language usage, spelling, and grammar. If you do not know anyone who can help you do this, you may wish to consider employing a professional scientific editing service. Upon resubmission, please provide the following: The name of the colleague or the details of the professional service that edited your manuscript RESPONSE: we have not used professional editing services. Three of our co-authors are native English-speakers so they assisted by editing the revised manuscript. 3. We note that the grant information you provided in the ‘Funding Information’ and ‘Financial Disclosure’ sections do not match. When you resubmit, please ensure that you provide the correct grant numbers for the awards you received for your study in the ‘Funding Information’ section. RESPONSE: we have provided the ‘Funding Information’ including the grant number. We ensure that the ‘Funding Information’ matches with ‘Financial Disclosure’. 4. We note that your Data Availability Statement is currently as follows: [All relevant data are within the manuscript and its Supporting Information files] Please confirm at this time whether or not your submission contains all raw data required to replicate the results of your study. Authors must share the “minimal data set” for their submission. PLOS defines the minimal data set to consist of the data required to replicate all study findings reported in the article, as well as related metadata and methods (https://journals.plos.org/plosone/s/data-availability#loc-minimal-data-set-definition). Authors do not need to submit their entire data set if only a portion of the data was used in the reported study. RESPONSE: The submission includes the aggregated data (minimal data set). The submission does not include facility-level data as the names of the facilities are confidential. 5. Please include a copy of Table 4 which you refer to in your text on page 12. RESPONSE: we have checked our manuscript and realized that we made an error. There is no Table 4. It should have been written as Table 2 which we have corrected in the revised manuscript. Additional Editor Comments: Authors need to revise the methodology based on the reviewer comments. Authors also need to revise the discussion and the conclusion based on the aim of this study. They need to explain more detail about the findings. [Note: HTML markup is below. Please do not edit.] RESPONSE: We have made some changes on Methods, Discussion and Conclusion based on comments from reviewers. The changes can be seen in the manuscript now revised with track changes. Reviewers' comments: Reviewer's Responses to Questions Comments to the Author Reviewer #1 1. This is a very interesting study with important findings. However, the study does not exactly follow WHO/HAI methodology while doing pricing calculations. This needs to be described clearly in the methods/discussion and limitations sections of the study. Kindly mention the following The study does not exactly follow a WHO/HAI methodology but a variation and the prices are reported in USD (instead of a median price ratio) This could be partly because of the absence of an updated international MSH drug pricing indicator guide (as the last one was published in 2015) RESPONSE: Thank you for your suggestion. We did not report price ratios as we felt no suitable external reference price (including one that lists prices for medical devices) was available. We did not report in Indonesian Rupiah as Plos One is a global journal. We have modified the Methods by providing information on the variation (i.e. price reporting in US$ instead of median price ratios or prices in local currency) that we made from the original version of WHO/HAI methodology (manuscript with track changes line 28-29, 177-178). We have also acknowledged the variation as the part of limitations of this study (manuscript with track changes line 536-538). 2. Also at places, sentences and paragraphs need support references (for example below) Thirdly, the lack of a universally accepted definition of affordability may impede the accurate comparison of our findings with those of other studies. RESPONSE: we have provided the references to support some sentences (Manuscript with track changes line 534,536) We agree the lack of a universally accepted definition of affordability is a challenge. The co-authors from HAI have lobbied WHO to develop a definition which we have been told is in process. Reviewer #2 1. Line 176: The authors have used 150 test strips. Is this for a month or the entire two years? If this is meant for a month, I would suggest to use the Indonesian guidelines. Indonesia, being a middle-income country, it is less likely for a diabetic to do 6-8 self-assessment per day. RESPONSE: 150 test strips are used for a month’s supply. If we refer to the Indonesian Guidelines for Diabetes Management published by Indonesian Association of Endocrinologist in 2021, the number of tests per day is not explicitly stated. However, the association recommends self-testing several times a day for uncontrolled patients including before each meal, 2 hours after each meal and before bedtime prior meals. The frequency of self-testing recommended in the Indonesian guideline is similar with that of American Diabetes Association. This is now stated in the revised manuscript. 2. Line 203-204: “As human insulin was not available in public health facilities, it is unsurprising that no insulin syringe was provided in this sector.” I tend to defer with the authors as to the unavailability of insulin syringes in public facilities. This is because of certain types of analogue insuring requires syringes for administration. Please re-look at this. RESPONSE: Currently analogue insulins in the Indonesian market are available only as pre-filled pens. Analogues in cartridges or vials require syringes to inject into pumps, but neither cartridges or vials were found. 3. Line 396-451. This section seems to be new and does not relate to the title and the flow of the rest of the document. If the authors need to include it, they need to either alter the title, or add another secondary objective of the study to match with the discussion RESPONSE: We do agree with the reviewers to modify our objectives (see manuscript with track changes line 138-139) Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0309350.r002
12 Aug 2024 Decision Letter - Diana Laila Ramatillah, Editor Availability, price and affordability of insulin, delivery devices and self-monitoring blood glucose devices in Indonesia PONE-D-24-04996R1 Dear Dr.Ramadaniati We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice will be generated when your article is formally accepted. Please note, if your institution has a publishing partnership with PLOS and your article meets the relevant criteria, all or part of your publication costs will be covered. Please make sure your user information is up-to-date by logging into Editorial Manager at Editorial Manager® and clicking the ‘Update My Information' link at the top of the page. If you have any questions relating to publication charges, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Diana Laila Ramatillah, PhD Academic Editor PLOS ONE Additional Editor Comments (optional): We have received all the revisions Reviewers' comments: https://doi.org/10.1371/journal.pone.0309350.r003
Formally Accepted
14 Aug 2024 Acceptance Letter - Diana Laila Ramatillah, Editor PONE-D-24-04996R1 PLOS ONE Dear Dr. Ramadaniati, I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now being handed over to our production team. At this stage, our production department will prepare your paper for publication. This includes ensuring the following: * All references, tables, and figures are properly cited * All relevant supporting information is included in the manuscript submission, * There are no issues that prevent the paper from being properly typeset If revisions are needed, the production department will contact you directly to resolve them. If no revisions are needed, you will receive an email when the publication date has been set. At this time, we do not offer pre-publication proofs to authors during production of the accepted work. Please keep in mind that we are working through a large volume of accepted articles, so please give us a few weeks to review your paper and let you know the next and final steps. Lastly, if your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. If we can help with anything else, please email us at customercare@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Prof Diana Laila Ramatillah Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0309350.r004

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