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IntroductionTight glycemic control and timely treatment can improve outcomes in patients with diabetes yet many remain sub-optimally controlled. The objective of the current study was to evaluate the effect of switching patients with sub-optimally controlled diabetes to the V-Go® (Valeritas Inc., Bridgewater, NJ, USA) Disposable Insulin Delivery device.MethodsA retrospective analysis of electronic medical records was conducted to assess patients with sub-optimal glycemic control defined as a glycated hemoglobin (HbA1c) >7%, switched to V-Go. Blood glucose control defined as change from baseline in HbA1c, prescribed insulin doses, body weight, concomitant anti-hyperglycemic agents, and reported hypoglycemia were collected prior to switching to V-Go and during V-Go use.ResultsTwo-hundred and four patients were evaluated during the study period. Overall, there was a significant decrease in HbA1c after switching to V-Go at the 14- and 27-week follow-up visits. The least-squares mean (LSM) change in HbA1c (95% confidence interval) from baseline to 14 weeks was −1.53% (−1.69% to −1.37%; P < 0.001), and from baseline to 27 weeks was −1.79% (−1.97% to −1.61%; P < 0.001). Significant reductions in mean HbA1c were achieved at both visits in all patient subsets: Patients with type 2 and type 1/latent autoimmune diabetes in adults (LADA); patients using insulin at baseline and patients naïve to insulin at baseline. Patients administering insulin at baseline required significantly less insulin on V-Go (86–99 LSM units/day at baseline to 58 LSM units/day at 27 weeks; P < 0.001). Across all patients, reported hypoglycemic events were no more frequent on V-Go than on previous therapy.ConclusionV-Go is safe and effective in patients with sub-optimally controlled diabetes requiring insulin therapy. Glycemic control improved significantly, less insulin was required, and hypoglycemic events were similar after patients switched to insulin delivery by V-Go.FundingValeritas, Inc.Electronic supplementary materialThe online version of this article (doi:10.1007/s13300-015-0138-7) contains supplementary material, which is available to authorized users.

IntroductionAdvances in insulin delivery have improved outcomes in patients with diabetes. This study evaluated the impact of V-Go® Wearable Insulin Delivery device on glycated hemoglobin (A1C) and insulin total daily dose (TDD) in patients with diabetes not achieving glycemic targets.MethodsElectronic medical record data was obtained for adult patients with A1C > 7% treated at a multicenter endocrine practice who initiated V-Go between August 2012 and August 2015. Data were collected at baseline and for up to four follow-up visits, and were analyzed overall, stratified by insulin use at baseline, and for patients prescribed a basal-bolus insulin regimen delivered by multiple daily injections (MDI) at baseline. Economic evaluations were conducted in patients previously prescribed MDI regimens.ResultsPatients (N = 103) were evaluated after a mean of 2, 6, 10, and 14 months of V-Go use. Baseline glycemic control was poor (A1C > 9%) in 59% of patients. Significant, sustained reductions in A1C compared with baseline were observed at every visit (p < 0.0001), with mean ± SE decrease of 1.67 ± 0.24% after 14 months. For patients prescribed insulin at baseline (n = 80), TDD was significantly reduced at all visits (p < 0.0001), with mean ± SE reduction of 17 ± 4.5 units/day at 14 months. Patients previously prescribed MDI therapy (n = 58) benefited from 1.53 ± 0.31% (p < 0.001) A1C reduction and TDD decrease of 30 ± 5 units/day after 14 months. Direct pharmacy wholesale acquisition costs for diabetes therapeutics were reduced by $25.00/patient/month.ConclusionUse of V-Go was associated with improved glycemic control and decreased TDD. For patients previously prescribed basal-bolus MDI therapy, switching to insulin therapy with V-Go resulted in pharmacy cost savings based on wholesale acquisition costs. V-Go offers an efficacious method of insulin delivery that improves outcomes in patients and can reduce costs.FundingValeritas, Inc.

BackgroundDiabetes is a chronic condition and when poorly controlled can lead to complications and death. Patients with glycated hemoglobin (A1C) measures >9 % are at significant risk for diabetes-related complications impacting the patient’s quality of life and imposing higher costs on the healthcare system. A1C reductions of 1 % or greater in this population have demonstrated substantial health and economic benefits. Reducing the percent of patients at risk is an essential component of quality-care measures established for patients with diabetes.ObjectiveTo evaluate if switching patients prescribed subcutaneous insulin injections to V-Go for insulin delivery would impact clinical and economic parameters in patients with poorly controlled diabetes (A1C > 9 %).MethodsThe study was a retrospective analysis using data extracted from the electronic medical records database of a multicenter diabetes system. Outcome measures included mean change in A1C from baseline, the percent of patients achieving a reduction in A1C ≥1 % while on V-Go therapy, and the impact to quality measures. In addition, economic analyses were conducted to assess the pharmacy budget impact and projected implication to total healthcare cost.ResultsNinety-seven patients were evaluated after a mean duration of 13.6 ± 6.9 weeks of insulin delivery with V-Go. Switching to V-Go resulted in an overall mean change (95 % CI) in A1C of −2.0 % (−1.7 to −2.3; p < 0.001) from a baseline of 10.5 %. Seventy-three percent of patients achieved an A1C reduction ≥1 %. Cost analysis supported a direct pharmacy savings of $119.30 (18.80–219.60, p = 0.020) per patient per month compared with baseline.ConclusionSwitching to V-Go for insulin delivery resulted in significant glycemic improvement and proved cost effective. This real-world assessment could be applied more broadly at the health system and plan level.

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