Eby Elizabeth L, Smolen Lee J, Pitts Amber C, Krueger Linda A, Andrews Jeffrey Scott
Economics and Health Policy, Medtronic, Inc., Minneapolis, Minnesota, USA.
Consult Pharm. 2014 Dec;29(12):813-22. doi: 10.4140/TCP.n.2014.813.
Estimate budgetary impact for skilled nursing facility converting from individual patient supply (IPS) delivery of rapid-acting insulin analog (RAIA) 10-mL vials or 3-mL prefilled pens to 3-mL vials.
A budget-impact model used insulin volume purchased and assumptions of length of stay (LOS), daily RAIA dose, and delivery protocol to estimate the cost impact of using 3-mL vials.
Skilled nursing facility.
Medicare Part A patients.
Simulations conducted using 12-month current and future scenarios. Comparisons of RAIA use for 13- and 28-day LOS.
RAIA costs and savings, waste reduction.
For patients with 13-day LOS using 20 units/day of IPS insulin, the model estimated a 70% reduction in RAIA costs and units purchased and a 95% waste reduction for the 3-mL vial compared with the 10-mL vial. The estimated costs for prefilled pen use were 58% lower than for use of 10-mL vials. The incremental savings associated with 3-mL vial use instead of prefilled pens was 28%, attributable to differences in per-unit cost of insulin in vials versus prefilled pens. Using a more conservative scenario of 28-day LOS at 20 units/day, the model estimated a 40% reduction in RAIA costs and units purchased, resulting in a 91% reduction in RAIA waste for the 3-mL vial, compared with 10-mL vial.
Budget-impact analysis of conversion from RAIA 10-mL vials or 3-mL prefilled pens to 3-mL vials estimated reductions in both insulin costs and waste across multiple scenarios of varying LOS and patient daily doses for skilled nursing facility stays.
评估熟练护理机构从使用10毫升瓶装或3毫升预填充笔式速效胰岛素类似物(RAIA)的个体化患者供应方式转换为使用3毫升瓶装时的预算影响。
一个预算影响模型,利用购买的胰岛素量以及住院时间(LOS)、每日RAIA剂量和给药方案的假设来估计使用3毫升瓶装的成本影响。
熟练护理机构。
医疗保险A部分患者。
使用12个月的当前和未来情景进行模拟。比较13天和28天住院时间的RAIA使用情况。
RAIA成本和节省情况、减少的浪费。
对于住院13天、每天使用20单位个体化患者供应胰岛素的患者,该模型估计与10毫升瓶装相比,3毫升瓶装的RAIA成本和购买单位减少70%,浪费减少95%。预填充笔的估计成本比使用10毫升瓶装低58%。使用3毫升瓶装而非预填充笔的增量节省为28%,这归因于瓶装胰岛素与预填充笔的单位成本差异。在更保守的情景下,住院28天、每天使用20单位,该模型估计RAIA成本和购买单位减少40%,与10毫升瓶装相比,3毫升瓶装的RAIA浪费减少91%。
对从10毫升瓶装或3毫升预填充笔式RAIA转换为3毫升瓶装进行的预算影响分析估计,在熟练护理机构住院的多种住院时间和患者每日剂量情景下,胰岛素成本和浪费均会降低。