Bazalo Gary, Weiss Richard C, Bouchard Jonathan R, Perry Ronald G, Wendt Frederick L, Jewell James L
Managed Solutions, LLC, Conifer, CO 80433, USA.
Consult Pharm. 2012 Jun;27(6):411-20. doi: 10.4140/TCP.n.2012.411.
To determine the impact on insulin acquisition cost of a pharmacy program to convert insulin utilization from multidose vials to pen-delivery systems for long-term care residents covered by Medicare Part A, and managed care plans.
Retrospective cost comparison.
Long-term care facilities.
Residents covered by Medicare Part A and managed care plans.
Policy to replace insulin vials with pen devices, effective July 2009.
Mean insulin cost-per-patient day (total insulin purchases divided by patient admission days) and pen utilization (pen purchases as a percent of total insulin purchases).
Insulin purchase data covered 2,405 admissions in 75 facilities over the 12-month period ending June 2010. Pen device purchases increased from less than 1% to almost 35% of total insulin purchases over the study period during which insulin cost per patient-day declined from $10.29 to $4.08. For Medicare Part A patients with admissions of 30 days or fewer, the most frequent visit type, mean cost per patient-day decreased from $13.73 to $9.19 as pen purchases increased from less than 1% to about 32%. For these same patients, mean cost per patient-day for admissions using only pen devices was $7.04, compared with $11.79 for admissions using only vials (P < 0.001). Significant differences in mean cost per patient-day were also found for residents covered by managed care and for longer admissions.
Total insulin costs can be reduced through higher utilization of pen devices by patients in long-term care facilities.
