Annual Inpatient and Insulin Costs Among Type 1 Diabetes Patients Treated with Multiple Daily Injections Versus Sensor-Augmented Pump Therapies

Presentation Number: MON 578
Date of Presentation: April 3rd, 2017

Cyrus Zhu*1, Janice K. Chung2, Megha Bansal1 and Max S Gill1
1Medtronic MiniMed, CA, 2Medtronic PLC

Abstract

Background and Aims

Multiple daily injections (MDI) therapy is a frequently used regimen for insulin-treated patients with type 1 diabetes (T1D). Continuous subcutaneous insulin infusion (CSII) with the use of continuous glucose monitoring (CGM) offers automated delivery of insulin via measurements of glucose levels (albeit with required blood glucose calibrations) which have been shown to improve clinical outcomes among T1D patients. The integration of CSII and CGM system called the sensor-augmented pump (SAP) therapy continues to advance the management of T1D with improved clinical outcomes

Methods

This study assessed annual inpatient and insulin costs from a private payer’s perspective for T1D patients treated with MDI and SAP. Data were extracted from Truven MarketScan® database (2010-2014) with a minimum 1 year follow-up time, since study index date. Specific algorithms were applied to define T1D patients on each treatment regimen. Analyses were restricted to patients (ages 18-64 years) with continuous enrollment to health plans in addition to pharmacy benefits, and continuously receiving insulin therapy from the study index date.

Results

Two cohorts (N=5,635 for both) were matched based on patient characteristics (e.g. age, sex, Charlson Comorbidity Index (CCI), indications for macrovascular and microvascular complications). Matched annual costs, adjusted to 2015 dollars, showed that the SAP treatment group had approximately 54% lower inpatient costs and 30% lower insulin costs, relative to MDI treatment. MDI treatment was also associated with an increased risk for inpatient utilization.

Conclusions

T1D patients on MDI therapy have higher inpatient and insulin costs compared to patients on SAP therapy from the payer’s perspective. The results suggest SAP therapy as one of the economical and clinical treatment options to improve management of T1D patients.

 

Disclosure: CZ: Employee, Medtronic Minimed. JKC: Employee, Medtronic Minimed. MB: Employee, Medtronic Minimed. MSG: Employee, Medtronic Minimed.