52-LB: Insulin Cost-Saving Estimate for Injection Technique (IT) Training in Subjects Injecting into Lipohypertrophy (LH)

Abstract

Background: LH with prevalence of 53.1% [1] among diabetic population in China, is one of the most common clinical complications related to injection therapy. IT training includes rotation of injection sites, adjustment of doses, stop needle reuse, etc. is an education intervention for those diabetic patients injecting into LH. Objective: This study aims to assess the effect of IT training on Total Daily Dose (TDD) of insulin for those diabetic patients injecting into LH and estimate the related insulin cost savings. Methods: A 6-month prospective randomized controlled trial carried out in 210 diabetic patients with LH in Tianjin. Patients in intervention group (n=106) were given IT training including avoiding injections into LH, reducing TDD by 10-20%, rotating injection sites, and stopping needle reuse. Patients in control group (n=104) kept their injection habits. The annual cost of insulin in China were calculated with the TDD, unit cost of insulin, the population of insulin therapy and insulin adherence rate. Unit costs of insulin was 0.25 RMB/IU [2], 9 million insulin injecting patients and 42% insulin therapy adherence in China [1] (the exchange rate is 1 USD =6.617 RMB in 2018). The discount rate was set as 3%. Results: The TDD for the control group and intervention group were 45.31(21.83) IU and 47.08(20.62) IU at 0 month and 45.06(21.29) IU and 40.53(19.97) IU at 6 months respectively. Patients in intervention group had a significant TDD decrease at 6.84 IU per day (P<0.05) after 6 months training. However, the TDD for control group only decreased at 0.91 IU per day. The estimated annual cost of decrease of insulin uptake because of IT training is approximately 1.37 billion RMB (207.0 million USD). Conclusion: IT training in patients with LH can significantly reduce the insulin uptake and then saving medical expenditure both from the patient and the healthcare sectors’ perspective. Thus, the IT training should be applied in a greater population with insulin therapy in China. Disclosure L. Chen: Research Support; Self; Becton, Dickinson and Company. Q. Xing: Research Support; Self; Becton, Dickinson and Company. J. Li: Research Support; Self; Becton, Dickinson and Company. J. Zhou: Research Support; Self; Becton, Dickinson and Company. Y. Hou: Employee; Self; Becton, Dickinson and Company. N. Yue: Employee; Self; Becton, Dickinson and Company. Y. Yuan: Employee; Self; Becton, Dickinson and Company. Funding Becton, Dickinson and Company