Regular Insulin Administered With the V-Go Disposable Insulin Delivery Device in a Clinical Diabetes Setting: A Retrospective Analysis of Efficacy and Cost.

Abstract

People with diagnosed diabetes incur high average medical expenditures of ∼$13,700 per year, creating a cost burden for themselves and their health plan insurers (1). According to the American Diabetes Association (ADA), 97% of the $245 billion cost for diabetes care in the United States is provided by government and commercial insurance payers (2). The cost of diabetes therapy, including insulin, accounts for 12% of the total cost of diabetes care, and managing diabetes to prevent complications is becoming less affordable (2). Insulin is still considered the most potent glucose-lowering agent available. ADA and the European Association for the Study of Diabetes recently issued guidelines for the treatment of type 2 diabetes that identified insulin replacement therapy as a key component of effective diabetes management over the course of the disease (3). The use of rapid-acting insulin analogs (RAIs) has surpassed the use of regular human insulin (RHI) in the majority of basal-bolus and bolus-only therapy regimens (4). Ninety-six percent of patients with type 2 diabetes who take insulin in the United States now use an analog insulin for basal and/or prandial coverage—an increase from just 19% in 2000 (5). This increase in utilization may be the result of many factors, including the pharmacokinetic differences among the insulins, marketing developments, and formulary health plan coverage (6). Along with this increase in the utilization of RAIs, there has been an increase in costs to patients and health plans. This is especially apparent when the costs of RAIs are compared to those of RHI as a therapy alternative. The steep increase in the cost of RAIs has led many patients to partially or totally discontinue their insulin therapy because of affordability issues (1). Several studies have shown that low adherence to diabetes therapy is also associated with higher medication costs …