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- Title
Insulin Administration Among Type 2 Diabetes Patients: Health Outcome and Economic Impact of Therapy Conversion to a Biphasic Insulin Analogue Pen.
- Authors
Lee, Won Chan; Balu, Sanjeev; Cobden, David; Joshi, Ashish; Pashos, Chris
- Abstract
Objective: To evaluate medication adherence, healthcare resource utilization, and associated costs of therapeutic conversion from insulin vial/syringe to a premixed biphasic insulin analogue pen among privately insured type 2 diabetes patients. Methods: An intra-patient, pre-post design was employed using a national managed care claims database. Adult patients with a diagnosis of type 2 diabetes converting from vial/syringe insulin to a prefilled biphasic insulin analogue pen device from July 2001 through December 2002 were identified. Primary endpoints were medication possession ratio [MPR]; hypoglycemic events; association between adherence, hypoglycemic events, and all-cause, hypoglycemia-attributable (HA), and other diabetes-attributable (DA) costs. Results: A total of 486 subjects met the inclusion criteria (mean [SD] age: 45.1 [13.7] years; 56.8% male). Post conversion, adherence was significantly improved (MPR: 59% to 68%; P < 0.01), and was associated with a significant decrease in the likelihood of experiencing a hypoglycemic event (OR = 0.40; 95% CI, 0.27-0.61; P < 0.05), with hypoglycemic incidences reduced nearly two-thirds among subjects with optimal adherence (MPR ≥ 80%; incidence rate ratio = 0.36; CI, 0.11-0.76; P < 0.05). Significant decreases in HA emergency department visits (OR = 0.36; CI, 0.16-0.84; P < 0.05) were also observed. Total mean all-cause annual treatment costs were reduced by $1748 per patient; P < 0.01, HA costs by $908 per patient; P < 0.01, and DA costs by $643 per patient; P < 0.01. Patients with MPR ≥ 80% were associated with significant reductions in all-cause healthcare costs (odds = 0.55; CI, 0.31-0.80; P < 0.05). Conclusions: Type 2 diabetes patients treated in a managed care setting may exhibit considerable improvements in health and economic outcomes upon insulin therapy conversion from vial/syringe to a biphasic insulin analogue pen.
- Subjects
INSULIN therapy; TYPE 2 diabetes treatment; PEOPLE with diabetes; PATIENT compliance; MEDICAL care use; MEDICAL care costs; MANAGED care programs
- Publication
Diabetes, 2007, Vol 56, pA122
- ISSN
0012-1797
- Publication type
Article