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Insulin use, costs increase for patients with type 2 diabetes
From 2000 to 2010, insulin use among patients with type 2 diabetes rose from 9.7% to 15.1%, with corresponding cost to the patient increasing from $19 to $36 per prescription, according to a research letter published in JAMA. Additionally, the usage percentages reversed from 96.4% of patients utilizing human synthetic insulin in 2000 to 91.5% using insulin analogs in 2010.
“Because insulin analogs have become increasingly popular, we examined trends in insulin use, out-of-pocket expenditures, and severe hypoglycemic events among privately insured US adults with type 2 diabetes from 2000 through 2010,” Kasia J. Lipska, MD, MHS, of the department of internal medicine, Yale University School of Medicine, and colleagues wrote.
Lipska and colleagues performed a retrospective analysis using a database of privately insured patients throughout the United States, although there were more enrollees in the South and Midwest. The analysis included patients aged at least 18 years, with at least 2 years of continuous enrollment between January 2000 and September 2010, and diagnosed with type 2 diabetes.
The research letter included data from 123,486 patients who filled at least one prescription of insulin. In 2000, those patients using insulin made up 9.7% (95% CI, 9.5-9.8) of those with type 2 diabetes; in 2010, they made up 15.1% (95% CI, 15-15.3).
“Among adults who used insulin, 96.4% (95% CI, 96-96.8) filled prescriptions for human synthetic insulin in 2000 and 14.8% (95% CI, 14.5-15.2) in 2010 (P<.001), whereas 18.9%
(95% CI, 18.2-19.7) filled prescriptions for insulin analogs in 2000 and 91.5% (95% CI, 91.2-91.8) in 2010 (P<.001),” the letter states.
In looking at out-of-pocket costs per prescription, the research showed that costs for all insulin types increased from $19 (interquartile range, $14-$23) in 2000 to $36 (interquartile range, $20-$53) in 2010 (P<.001).
“We found a large increase in the prevalent use of insulin analogs among privately insured patients with type 2 diabetes,” they wrote. “The clinical value of this change is unclear.”
Disclosure: This project was supported by a grant from the Agency for Healthcare Research and Quality. Please see letter for full list of disclosures.