Affordability over perceived safety: Consumer acceptance of emerging insulin production technologies

Abstract Insulin affordability remains a significant challenge for many individuals with diabetes, creating interest in alternative production technologies that may reduce costs and expand supply. This study examines consumer acceptance of insulin produced via a gene-edited production system compared with insulin produced using conventional genetically modified microbial methods. A discrete choice experiment was administered to U.S. adults diagnosed with diabetes ( n = 386), in which respondents evaluated insulin alternatives varying by production technology and out-of-pocket cost. A mixed logit model was used to estimate willingness to pay and assess preference heterogeneity. Results indicate that out-of-pocket cost was the primary factor influencing insulin choice, with respondents exhibiting strong sensitivity to out-of-pocket costs. On average, respondents expressed acceptance of gene-edited insulin, and relative perceived safety was positively associated with willingness to pay for the product. Additional analysis revealed substantial heterogeneity in consumer preferences across respondents. Collectively, these findings suggest that affordability plays a more influential role than perceived safety in shaping consumer acceptance of emerging biotechnology-based insulin production systems and provide insights for stakeholders considering future commercialization pathways for insulin.