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Res Social Adm Pharm. 2019 Sep;15(9):1126-1132. doi: 10.1016/j.sapharm.2018.09.016. Epub 2018 Sep 26.
Insulin is one of the most efficacious treatments for hyperglycemia; however, adherence to insulin therapy is poor, impacting its efficacy. Thus, the objectives of this study were to determine if persistent use of a new insulin delivery option, V-Go, improved clinical outcomes and secondly compare clinical and economic outcomes between persistent use of V-Go and conventional insulin delivery (CID).
A retrospective review of an outpatient clinic's records was performed. Patients initiating V-Go with documented persistent use of V-Go or resumed persistent use of CID after short-term V-Go use were included (≥5 months of persistency). Baseline data and a total of two post-V-Go or CID initiation visits were examined for clinical and economic outcomes. Cost-effectiveness of each therapy was calculated by dividing the mean cost difference (baseline to office visit 2) by the mean change in A1c (baseline to office visit 2).
V-Go persistent patients had a significant decrease in A1c (-1.42; p < 0.001). Between baseline and office visit two, they required less insulin units/day and units/kg and had significantly lower A1c, insulin units/day, insulin units/kg, and 30-day insulin costs than CID patients. V-Go persistent patients had a lower incremental cost by $695.61 per 1% change in A1c compared to CID persistent patients.
Utilization of a new insulin delivery option resulted in improved clinical outcomes compared to CID and was more cost-effective. Clinicians and health plans should consider the use of new insulin delivery options for the management of patients with diabetes on insulin therapy to promote persistence.
胰岛素是治疗高血糖最有效的方法之一;然而,患者对胰岛素治疗的依从性很差,这影响了其疗效。因此,本研究的目的是确定持续使用新的胰岛素输送方案 V-Go 是否能改善临床结局,其次比较 V-Go 持续使用与传统胰岛素输送(CID)的临床和经济结局。
对一个门诊诊所的记录进行了回顾性审查。纳入了开始使用 V-Go 且有持续使用 V-Go 记录或在短期使用 V-Go 后恢复持续使用 CID(≥5 个月)的患者。检查了基线数据和总共两次 V-Go 或 CID 起始后的就诊的临床和经济结局。通过将平均成本差异(基线至就诊 2)除以 A1c 的平均变化(基线至就诊 2)来计算每种治疗方法的成本效益。
V-Go 持续使用患者的 A1c 显著下降(-1.42;p<0.001)。与基线和就诊 2 相比,他们每天需要的胰岛素单位和每公斤胰岛素单位减少,A1c、每天胰岛素单位、每公斤胰岛素单位和 30 天胰岛素费用明显更低。与 CID 持续使用患者相比,V-Go 持续使用患者每 1% A1c 变化的增量成本低 695.61 美元。
与 CID 相比,新胰岛素输送方案的使用可改善临床结局,且更具成本效益。临床医生和医疗计划应该考虑为接受胰岛素治疗的糖尿病患者使用新的胰岛素输送方案来促进其坚持治疗。