The Clinical and Economic Impact of the V-Go® Disposable Insulin Delivery Device for Insulin Delivery in Patients with Poorly Controlled Diabetes at High Risk

Abstract

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.

A Pragmatic Clinical Trial to Compare the Real-World Effectiveness of V-Go versus Standard Delivery of Insulin in Patients with Advanced Type 2 Diabetes

“…Patients in the V-Go group reported a 24% reduction in TDD U/day and a 25% reduction in TDD U/kg while patients in the STO group reported no changes in TDD. Our observation of decreased insulin utilization after initiation of V-Go is consistent with previous research 8, [18][19][20]22 and supports the theory that continuous insulin infusion may be more efficient than insulin delivery via single or multiple injections. 14,18 Patients in the V-Go as well as the STO group were generally satisfied with their insulin delivery device at baseline and EOS, with average TRIM-Diabetes Device scores in the 70s and 80s on a 100-point scale.…”

Clinical Benefits Over Time Associated with Use of V-Go Wearable Insulin Delivery Device in Adult Patients with Diabetes: A Retrospective Analysis

“…In a small survey, V-Go was perceived by patients to be easy to use, discreet, and comfortable to wear [ 19 ]. Multiple studies support the effectiveness of V-Go in significantly reducing A1C, demonstrating decreases in mean A1C of 1.2–2.0% [ 16 – 20 , 28 , 29 ]. In a study by Rosenfeld et al, mean A1C decreased by 1.2% after switching to V-Go, and after V-Go was stopped, A1C increased by 0.6%.…”

Regular Insulin Administered With the V-Go Disposable Insulin Delivery Device in a Clinical Diabetes Setting: A Retrospective Analysis of Efficacy and Cost

“…This retrospective chart analysis provides an observation of the change in cost and glycemic control when RHI was administered with the V-Go disposable insulin delivery device in a real-world setting. V-Go has proven to be an appropriate therapy for a broad range of patients, resulting in significantly reduced A1C levels ( 19 , 20 ). Stability studies have been conducted for the administration of U-100 RHI with V-Go, and RHI was found to be stable in this delivery device ( 21 ).…”