Medication adherence and the associated health-economic impact among patients with type 2 diabetes mellitus converting to insulin pen therapy: An analysis of third-party managed care claims data

Lee, Won Chan; Balu, Sanjeev; Cobden, D; Joshi, Ashish V.; Pashos, Chris L.

doi:10.1016/j.clinthera.2006.10.004

Cited by 239 publications

(234 citation statements)

References 39 publications

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“…If a patient/caregiver is certain that the pen device is delivering insulin in accurate doses, it may help to improve adherence to treatment. Studies in adults and adolescents with diabetes show that improving adherence is associated with improved HbA1c levels, whilst decreasing the incidence of hypoglycaemia and the number of hypoglycaemiaassociated hospital and physician visits (14,24).…”

Section: Dosing Accuracymentioning

confidence: 99%

“…Notably, insulin pens have been found to be easier to use and transport, provide more accurate dosing, reduce the fear associated with needles, reduce injection pain when used with the short, fine (5-6 mm and 30-32 gauge) needles, and reduce the embarrassment of injecting in public (1, 4,5,8,[12][13][14][15][16]. Furthermore, insulin pens are associated with patient preference and improved adherence compared with the vial and syringe method of insulin delivery (4).…”

Section: Features and Benefits Of Insulin Pensmentioning

confidence: 99%

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Insulin delivery by injection in children and adolescents with diabetes

Hanås¹,

Beaufort²,

Hoey³

et al. 2011

Pediatric Diabetes

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Section: Dosing Accuracymentioning

confidence: 99%

Section: Features and Benefits Of Insulin Pensmentioning

confidence: 99%

Insulin delivery by injection in children and adolescents with diabetes

Hanås¹,

Beaufort²,

Hoey³

et al. 2011

Pediatric Diabetes

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“…Despite the plethora of evidence from various randomised clinical trials confirming the benefits of basal insulin analogue therapy in the management of diabetes, the extent to which these results translates in real life clinical practice is unclear [16] [17]. Several observational studies have attempted to address this issue but those studies were conducted in the Caucasian population [18] [19].…”

Section: Introductionmentioning

confidence: 99%

Effect of Initiation of Basal Insulin Glargine on Glycemic Control in Patients with Diabetes: Real Life Experience from Hong Kong

Yeung¹,

Fhkam²,

Ngai³

et al. 2017

JDM

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Introduction: To assess the changes in glycemic control after initiating or switching to a basal insulin analogue in patients with diabetes mellitus. Methods: A retrospective, observational analysis was conducted using electronic data from a Hong Kong regional hospital. Data from adult patients with type 1 and 2 diabetes mellitus (T1DM and T2DM, respectively) who had been prescribed with basal insulin glargine in 2008-2010, with recorded HbA1c levels at the time of initiation, at 6 and 12 months thereafter, were analysed. Results: Data from 106 eligible patients were analysed. Substantial reduction in HbA1c and fasting sugar levels were reported in both T1DM (∆ HbA1c = 1.5%, ∆ FBG = 1.3 mmol/L p < 0.05) and T2DM (∆ HbA1c = 1.2%, ∆ FBG = 2.9 mmol/L p < 0.05) patients after 12 months of therapy. A total of 42% of T1DM and 26% of T2DM patients achieved HbA1c levels < 7.0%. After adjustment, T2DM patients who were insulin naive achieved a statistically greater HbA1c reduction (∆ = 1.7%) than those who previous treated with premixed or basal bolus insulin (∆ = 0.3%) (p < 0.05). Percentage of patients experiencing hypoglycaemia reduced from 69% to 62% in T1DM but increased from 26% to 36% in T2DM patients. All hypoglycaemic episodes recorded were either asymptomatic or mild and self-limiting. Only 4% of the patients discontinued treatment at the end of 12 months. Conclusions: In real life clinical practice, a single daily basal insulin analogue therapy provided effective glycemic control with an acceptable risk of mild hypoglycaemia.

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“…There have been some studies evaluating treatment adherence, healthcare resource utilization and the associated costs of therapy conversion from vial/syringe to insulin pen. In the paper by Lee et al 23 performed in the USA, the economic evaluation of insulin pens vs cartridges showed that the use of insulin pens significantly improved medication adherence, reduced hypoglycemic events and lowered treatment costs. In this study the total annual costs of insulin therapy (including the costs of insulin and delivery devices) were reduced by 1600 USD per patient who switched from vial and syringe to pen, the hypoglycemia costs were reduced by 800 USD and the costs of diabetes-attributable healthcare were reduced by 600 USD.…”

Section: The Health-economic Impact Of the Insulin Pen Therapymentioning

confidence: 99%

Insulin therapy in the hospital setting: a time for a change?

et al. 2016

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The number of people with diabetes mellitus worldwide is expected to be more than double from 171 million in 2000 to 366 million in 2030. Approximately 25% of all hospital inpatient days are affected by diabetes. In Italy there are more than 12,000 hospitalizations excesses for 100,000 people per year, with a huge economic impact. Ever since its discovery in the 1920s, insulin has been the milestone of type 1 diabetes treatment and its use is increasingly necessary for the successful management of type 2 diabetes. Often patients believe that injecting insulin can be painful, inconvenient and embarrassing; generally they are afraid of gaining weight and of hypoglycemia. On the other side, physician's concerns regarding insulin administration include potential dosing errors and patient non-compliance. Ever since its discovery in the mid-1920s, insulin was administered subcutaneously using a vial and syringe. In 1985 the first pen device was launched. Currently disposable insulin pens are the most used and preferred by patients in the daily use, but are not routinely used for diabetic inpatients. In this paper we will focus on the pros and cons of insulin administration with pens in the hospital setting.

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Medication adherence and the associated health-economic impact among patients with type 2 diabetes mellitus converting to insulin pen therapy: An analysis of third-party managed care claims data

Cited by 239 publications

References 39 publications

Insulin delivery by injection in children and adolescents with diabetes

Insulin delivery by injection in children and adolescents with diabetes

Effect of Initiation of Basal Insulin Glargine on Glycemic Control in Patients with Diabetes: Real Life Experience from Hong Kong

Insulin therapy in the hospital setting: a time for a change?

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