Abstract
IntroductionAdvances in insulin delivery have improved outcomes in patients with diabetes. This study evaluated the impact of V-Go® Wearable Insulin Delivery device on glycated hemoglobin (A1C) and insulin total daily dose (TDD) in patients with diabetes not achieving glycemic targets.MethodsElectronic medical record data was obtained for adult patients with A1C > 7% treated at a multicenter endocrine practice who initiated V-Go between August 2012 and August 2015. Data were collected at baseline and for up to four follow-up visits, and were analyzed overall, stratified by insulin use at baseline, and for patients prescribed a basal-bolus insulin regimen delivered by multiple daily injections (MDI) at baseline. Economic evaluations were conducted in patients previously prescribed MDI regimens.ResultsPatients (N = 103) were evaluated after a mean of 2, 6, 10, and 14 months of V-Go use. Baseline glycemic control was poor (A1C > 9%) in 59% of patients. Significant, sustained reductions in A1C compared with baseline were observed at every visit (p < 0.0001), with mean ± SE decrease of 1.67 ± 0.24% after 14 months. For patients prescribed insulin at baseline (n = 80), TDD was significantly reduced at all visits (p < 0.0001), with mean ± SE reduction of 17 ± 4.5 units/day at 14 months. Patients previously prescribed MDI therapy (n = 58) benefited from 1.53 ± 0.31% (p < 0.001) A1C reduction and TDD decrease of 30 ± 5 units/day after 14 months. Direct pharmacy wholesale acquisition costs for diabetes therapeutics were reduced by $25.00/patient/month.ConclusionUse of V-Go was associated with improved glycemic control and decreased TDD. For patients previously prescribed basal-bolus MDI therapy, switching to insulin therapy with V-Go resulted in pharmacy cost savings based on wholesale acquisition costs. V-Go offers an efficacious method of insulin delivery that improves outcomes in patients and can reduce costs.FundingValeritas, Inc.
Highlights
Advances in insulin delivery have improved outcomes in patients with diabetes
Use of V-Go was associated with improved glycemic control and decreased total daily dose (TDD)
For patients previously prescribed basal-bolus multiple daily injections (MDI) therapy, switching to insulin therapy with V-Go resulted in pharmacy cost savings based on wholesale acquisition costs
Summary
This study evaluated the impact of V-GoÒ Wearable Insulin Delivery device on glycated hemoglobin (A1C) and insulin total daily dose (TDD) in patients with diabetes not achieving glycemic targets. Data were collected at baseline and for up to four follow-up visits, and were analyzed overall, stratified by insulin use at baseline, and for patients prescribed a basal-bolus insulin regimen delivered by multiple daily injections (MDI) at baseline. Despite the availability of many non-insulin glucose-lowering medications (NIGLM), 50% of patients with diabetes fail to achieve A1C targets [5]. Patients as well as physicians report the two most common difficulties that impact adherence are the number of daily injections required and taking insulin at the prescribed time or with meals on a daily basis [8]. It is important to differentiate between a prescribed regimen that is inadequate and needs to be adjusted, and an appropriate insulin regimen that is not being adhered to
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