Impact of a pharmacist-driven insulin dispensing program in a management services organization

Abstract

BackgroundInsulin prices have tripled in the United States over the past decade. The affordability of insulin products may affect patient adherence and, as a result, glucose control. Providers may need to consider less expensive insulin options to improve patient outcomes. ObjectiveThis study aimed to evaluate the impact of a low-cost, in-office insulin dispensing program led by pharmacists in a management services organization on patient glucose control, adherence to routine laboratory tests, and patient satisfaction. MethodsThis multicenter, retrospective cohort study was conducted at 2 primary care clinics in South Florida. The primary outcome was the change in mean hemoglobin A1c (HbA1c) at baseline versus 6 months after insulin program enrollment. The secondary outcomes included mean HbA1c at baseline versus 12 months after insulin program enrollment, patient satisfaction evaluated with a survey, and adherence to routine laboratory tests, specifically HbA1c and urine albumin to creatinine ratio before and after enrollment. ResultsA total of 21 patients met inclusion criteria. The mean HbA1c before program enrollment was 9.4% compared with a mean HbA1c of 8.6% 6 months after enrollment (P = 0.058) and 8.4% 12 months after enrollment when available (P = 0.097). Of the 12 patients who completed the patient satisfaction survey, 11 (91.7%) agreed or strongly agreed that they were satisfied with pharmacist involvement in insulin management and planned to continue using the insulin program. ConclusionAmong patients with type 2 diabetes enrolled in a low-cost, in-office insulin program, change in mean HbA1c after 6 and 12 months was not statistically significant.