Theys Kristof, Vermander Sofie, Annemans Lieven, De Block Christophe, Hermans Michel P, Matthys Imke, Nobels Frank, Nguyen Trung, Preumont Vanessa, Zakrzewska Katerina, Vanderdonck Frank
AxTalis B.V., Gentbrugge, Belgium.
Department of Public Health and Primary Care, Interuniversity Center of Health Economic Research (ICHER), Ghent University, Ghent, Belgium.
Pharmacoecon Open. 2025 Mar;9(2):259-270. doi: 10.1007/s41669-024-00547-x. Epub 2024 Dec 15.
Adequate insulin injection technique (IIT) is crucial to optimize the efficacy of diabetes therapy. Widespread non-practice of injection-site rotation and frequent reuse of insulin pen needles (PN) promote high rates of lipohypertrophy (LH) among people living with diabetes (PwD). LH is associated with increased insulin requirement and suboptimal insulin absorption leading to worsened glycemic control and increased risk for hypoglycemia. Avoiding out-of-the-pocket patient costs of PN could reduce PN reuse, thereby limiting its contribution to LH occurrence.
A model was developed to compute the impact of a behavior shift in reuse on clinical and economic outcomes for type 1 and insulin-treated type 2 diabetes populations in Belgium.
Patient populations were characterized by treatment-specific characteristics and grouped by their frequency of PN replacement. The intervention was modelled to cause a change in reuse frequency, with the effects propagating downstream of the model. Model and input parameters were based on literature research and expert opinions from a Delphi panel, since available data was found to be limited, incomplete or inconsistent and assumptions were needed.
Using the current situation as comparator, this analysis showed a reduction of healthcare expenditures following an improvement in IIT. Considering a 5-year time horizon, this study yields potential savings of 52.6 million euros (28.1-77.9 million euros) when 55% of PwD improve PN reuse behavior.
Our model shows that even in an era of technological advances and established diabetes care, lack of adherence to correct IIT has an important impact on economic and health outcomes of PwD in Belgium.
适当的胰岛素注射技术（IIT）对于优化糖尿病治疗效果至关重要。糖尿病患者（PwD）中普遍不进行注射部位轮换且频繁重复使用胰岛素笔针头（PN），导致脂肪增生（LH）发生率很高。LH与胰岛素需求量增加和胰岛素吸收欠佳相关，进而导致血糖控制恶化以及低血糖风险增加。避免患者自掏腰包购买PN可能会减少PN的重复使用，从而限制其对LH发生的影响。
建立一个模型，以计算比利时1型糖尿病患者和胰岛素治疗的2型糖尿病患者重复使用行为转变对临床和经济结果的影响。
根据特定治疗特征对患者群体进行特征描述，并按PN更换频率进行分组。对干预措施进行建模，使其导致重复使用频率发生变化，其影响在模型下游传播。由于现有数据有限、不完整或不一致且需要进行假设，模型和输入参数基于文献研究和德尔菲小组的专家意见。
以当前情况作为对照，该分析表明IIT改善后医疗保健支出有所减少。考虑到5年的时间范围，当55%的糖尿病患者改善PN重复使用行为时，本研究可节省5260万欧元（2810万至7790万欧元）。
我们的模型表明，即使在技术进步和糖尿病护理成熟的时代，不遵守正确的IIT对比利时糖尿病患者的经济和健康结果仍有重要影响。
