Assessment of adherence and healthcare costs of insulin device (FlexPen®) versus conventional vial/syringe

Başer, Onur; Bouchard, Jonathan; DeLuzio, Tony; Henk, Henry J.; Aagren, Mark

doi:10.1007/s12325-010-0009-6

Cited by 54 publications

(59 citation statements)

References 13 publications

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“…Baser 12 had a low quality score, related to the lack of explicit ways to consider confounding factors and to not reporting confidence intervals in the results; they reported, however, standard deviations. Experimental studies had high risk of bias; the main issues were nonblinded design and insufficient explanation of randomization method.…”

Section: Resultsmentioning

confidence: 99%

“…A nonnaïve population 23,26 showed a less marked trend, with important heterogeneity (I 2 = 80%; χ 2 significant). Baser et al 12 reported that mean change in MPR in patients who exchanged vial for pen device was 0.22 ± 0.01, compared with 0.13 ± 0.36 for those who continued on vial (P = .0011). Two studies evaluated the proportion of patients with MPR > 0.80: Lee et al 23 showed difference favoring pen (0.546 vs 0.361; P < .01), and Buysman et al, 13 using a logistic regression model, found an OR = 1.39 (95% CI 1.04-1.85) favoring pen, after adjusting for age, gender, and comorbidities.…”

Section: Adherencementioning

confidence: 98%

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Pen Devices for Insulin Self-Administration Compared With Needle and Vial

Lasalvia

Barahona-Correa

Romero-Alvernia

et al. 2016

J Diabetes Sci Technol

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Objectives: Pen devices offer advantages compared with vial and syringe (VaS). The purpose of this article was to evaluate efficacy of pen devices compared to VaS. Methods: A systematic review of literature was performed in 8 different databases. References were independently screened and selected. Primary observational or experimental studies comparing pen devices with VaS for insulin administrations were included. Studies on specific populations were excluded. Risk of bias was evaluated using appropriate tools. Data on glycosylated hemoglobin (HbA1c), hypoglycemia, adherence, persistence, patient preference, and quality of life (QOL) were collected. Meta-analysis was performed when appropriate. Heterogeneity and risk of publication bias were evaluated. Otherwise, descriptive analyses of the available data was done. Results: In all, 10 348 articles were screened. A total of 17 studies were finally selected: 7 experimental and 10 analytical. The populations of the included articles were mainly composed of adults with type 2 diabetes mellitus. Important risk of bias was found in all of the articles, particularly experimental studies. Meta-analyses were performed for HbA1c, hypoglycemia, adherence and persistence. Pen device showed better results in mean HbA1c change, patients with hypoglycemia, adherence and persistence compared to VaS. No difference was observed in number of patients achieving <7% HbA1c. Preference studies showed a tendency favoring pen devices, however nonvalidated tools were used. One QoL study showed improvements in some subscales of SF-36. Conclusions: There is evidence that pen devices offer benefits in clinical and, less clearly, patient-reported outcomes compared to VaS for insulin administration. However, these results should be taken with caution.

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Section: Resultsmentioning

confidence: 99%

Section: Adherencementioning

confidence: 98%

Pen Devices for Insulin Self-Administration Compared With Needle and Vial

Lasalvia

Barahona-Correa

Romero-Alvernia

et al. 2016

J Diabetes Sci Technol

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“…Medication possession ratio (MPR) will be assessed by estimating the number of days that patients had possession of the study drug based on the prescription date and days of supply [35]. An MPR of 80% will define patients as being persistent on study medication.…”

Section: Outcomes Of Interestmentioning

confidence: 99%

Achieve control: a pragmatic clinical trial of insulin glargine 300 U/mL versus other basal insulins in insulin-naïve patients with type 2 diabetes

Oster

Sullivan

Dalal

et al. 2016

Postgraduate Medicine

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“…Treatment adherence was measured by both the traditional medication possession ratio (MPR) and the adjusted MPR (aMPR), which takes into account the differences in insulin device package size. 27 For example, insulin glargine is packaged in either 10 mL vials with a total of 1000 units, or 3 mLF disposable pens in a package of 5 pens with a total of 1500 units. aMPR was calculated by multiplying the traditional MPR (the total days' supply of all filled study drug prescriptions in the analysis period, divided by the number of days in the analysis period) by the average days between prescription refills divided by the average days' supply for patients using insulin.…”

Section: Follow-up Study Outcomesmentioning

confidence: 99%

Does Device Make Any Difference? A Real-world Retrospective Study of Insulin Treatment Among Elderly Patients With Type 2 Diabetes

Miao

Wei

Lin³

et al. 2014

J Diabetes Sci Technol

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Background: We compared real-world clinical and economic outcomes for insulin glargine treatment administered by disposable pen and traditional vial-and-syringe injections among elderly patients with type 2 diabetes mellitus (T2DM). Methods: Using a large database of US retirees, this retrospective longitudinal study examined 1-year follow-up outcomes in patients with T2DM aged 65 years or older who were either insulin naïve and initiated insulin glargine via disposable pen (pen initiators [PI]) or vial (vial initiators [VI]) or were already insulin glargine users but either continued with a vial (vial continuers [VC]) or switched to a disposable pen (pen switchers [PS]). Results: There were 7856 propensity-score-matched patients, including 2930 each in the PI and VI cohorts, and 998 each in the VC and PS cohorts. Compared with vial-and-syringe users, the disposable pen users had significantly greater treatment persistence (P < .0001 for both comparisons), duration of persistence (P < .0001 for both), and adherence (P < .01 for both) and lower insulin daily average consumption (P < .05 for both). Compared with the VI cohort, the PI cohort had significantly fewer hypoglycemia-related events (P = .0164). Total health care costs were comparable for the respective matched cohorts. Conclusions: In elderly patients with T2DM receiving insulin glargine therapy, initiating or switching to a disposable pen was associated with better treatment persistence and adherence than initiating or continuing with vial-and-syringe, without increased total health care costs. Among insulin-naïve patients, initiating insulin glargine by disposable pen was also associated with significantly reduced risk of hypoglycemia compared with vial-and-syringe patients.

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Assessment of adherence and healthcare costs of insulin device (FlexPen®) versus conventional vial/syringe

Abstract: Without significant addition to the cost, insulin administration with FlexPen is associated with an improved adherence among patients who switched from vial-based insulin administration.

Cited by 54 publications

References 13 publications

Pen Devices for Insulin Self-Administration Compared With Needle and Vial

Pen Devices for Insulin Self-Administration Compared With Needle and Vial

Achieve control: a pragmatic clinical trial of insulin glargine 300 U/mL versus other basal insulins in insulin-naïve patients with type 2 diabetes

Does Device Make Any Difference? A Real-world Retrospective Study of Insulin Treatment Among Elderly Patients With Type 2 Diabetes

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