1167-P: CSII and Insulin: Does Extending the Wear Duration of Infusion Sets Save Expensive Insulin?

Abstract

Objective: Patients using continuous subcutaneous insulin infusion (CSII) as a means of insulin delivery are advised to replace their infusion set every 2-3 days, as the probability of adverse events related to insertion increases after 72 hours, according to labeling and manufacturer’s instructions. When the infusion set is changed the remaining unused insulin in the reservoir and infusion set tubing are usually thrown away. The potential savings associated with extending the duration of infusion set wear from 2-3 days to 7 days was determined from the perspective of insulin pump users. Method: The discarded insulin volume in the reservoir and infusion set under a current-wear scenario of 2-3 days versus 7 days was modeled. A mix of best-case (use for a 3-day set/reservoir with the shortest length of tubing) and worst-case (normal use for a 3-day set/reservoir with longest tubing) scenarios was used. Insulin cost savings were computed for the 3-day scenario assuming a complete infusion set and reservoir change every 3 days. Under the 7-day scenario, a complete infusion set change occurred every 7 days, while the reservoir was changed midway between complete changes. Under the best-case scenario, reservoirs were discarded by the end of 7 days. Results: For the insulin pump users, the average annual reduction in discarded insulin volume was calculated to save about 5-10 vials of insulin per year per pump user. The corresponding cost reduction per user due to insulin savings was ∼$1,500 to $3,000 per year per pump user (based on ∼ $300/insulin vial; IBM Micromedex Red Book). Conclusion: Using infusion sets that last for 7 days can yield substantial savings to patients, private health plans, and other payers (e.g., Centers for Medicare and Medicaid Services). Work is in progress to assess environmental impact cost savings due to reduction in material waste when extending the duration of infusion set wear from 2-3 days to 7 days. Disclosure S. Chattaraj: Employee; Self; Medtronic. M. Fienup: Employee; Self; Medtronic. G. Zhang: None. M. Tieck: None.