Effect of adherence and insulin delivery system on clinical and economic outcomes among patients with type 2 diabetes initiating insulin treatment

Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Rajeev AyyagariEric Q Wu

Abstract

Adherence to insulin affects real-world health outcomes and may itself be affected by the choice of insulin delivery device (pen or vial/syringe). The choice of insulin delivery device may also have direct effects on effectiveness. This study aimed to estimate the effects of insulin adherence and delivery device on real-world health outcomes. This study included adults with type 2 diabetes mellitus initiating insulin, with continuous health plan insurance for 6 or more months before initiation (baseline) and 1 or more year after. Measured outcomes included glycosylated hemoglobin (Hb A1c) reduction, hospitalization rate, total health care costs, and pharmacy costs over 1 year of follow-up. Adherence (defined as having insulin fills sufficient for the entire quarter), pen or vial/syringe use, and disease-related patient characteristics were assessed in each quarter. To account for the time-varying relationship between adherence, patient characteristics, and outcomes, marginal structural generalized linear models were used to estimate the effect of adherence and device use. Mean outcomes were predicted for different combinations of adherence and device choice. Among the 13,428 patients (mean age 54 years; 46% women; baseline Hb A...Continue Reading

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Citations

Oct 27, 2016·Journal of Managed Care & Specialty Pharmacy·Samuel StolpeTami Wisniewski
Apr 6, 2018·Journal of Diabetes Science and Technology·Eric Zijlstra
May 6, 2019·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Carol M HamerskyNeeraj N Iyer
Apr 21, 2018·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Lawrence BlondeBruno Guerci
Apr 13, 2018·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Magaly Perez-NievesMaureen J Lage
Apr 3, 2020·Diabetes Technology & Therapeutics·Arvind GuptaDebmalya Sanyal
Sep 25, 2016·Journal of Diabetes Science and Technology·Harald PohlmeierDavid Klonoff
Oct 11, 2017·Journal of Diabetes Science and Technology·Eric ZijlstraThomas Forst
Mar 6, 2021·Journal of Diabetes Science and Technology·Devin SteenkampBirong Liao

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