Cost Change After Initiating Basal Insulin for 6 Months in Patients with Type 2 Diabetes: A Registry Study in China

Dongshan Zhu; Xian Li; Jiachao Ji; Juming Lu; Weiping Jia; Linong Ji; Puhong Zhang

doi:doi:10.11648/j.ijde.20190403.11

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Cost Change After Initiating Basal Insulin for 6 Months in Patients with Type 2 Diabetes: A Registry Study in China

Dongshan Zhu, Xian Li, Jiachao Ji, Juming Lu, Weiping Jia, Linong Ji, Puhong Zhang

Published in International Journal of Diabetes and Endocrinology (Volume 4, Issue 3)

Received: 18 July 2019 Accepted: 13 August 2019 Published: 3 September 2019

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Abstract

This study aims to examine short-term treatment cost changes after initiating basal insulin in insulin naïve patients with type 2 diabetes for 6 months in routine clinical practice. Observational Registry of Basal Insulin Treatment (ORBIT) program is a 6-month, prospective study in China. Patients with type 2 diabetes inadequately controlled (HbA1C≥7%) by oral antidiabetic drugs (OADs) and willing to initiate basal insulin treatment were enrolled from 209 hospitals of eight geographic regions of China. Type and dose of BI were at the physician’s discretion and patients’ willingness. Interviews were conducted at baseline, month 3 and month 6. Daily treatment cost (including cost of OAD medication, insulin therapy, self-monitoring of blood glucose and dealing with minor hypoglycemia) of per person before and after adding BIs was evaluated. After adding on Basal insulin, the weighted mean ± standard deviation (SD) daily treatment cost for insulin-naïve patients with type 2 diabetes increased from $1.25 ± $0.74 (baseline) to $2.57 ± $0.68 at month 6, a median (Q1, Q3) increase of 1.51 (0.38, 4.11) times over 6 months. The daily treatment cost increased with growing baseline HbA1c level and prolonged diabetes duration. The reduction in HbA1c was 2.2%, with minor hypoglycemia increased by 0.68 times/person/year. Insulin cost accounted for the highest proportion (47.9%) of costs. Our findings suggest adding-on BI therapy may increase the daily treatment cost by 1.5 times at 6 months. Early initiation of BI therapy may provide an opportunity to achieve treatment goals with low cost and low risk of hypoglycemia.

Published in	International Journal of Diabetes and Endocrinology (Volume 4, Issue 3)
DOI	10.11648/j.ijde.20190403.11
Page(s)	62-72
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Basal Insulin, Cost, Type 2 Diabetes

References

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APA Style

Dongshan Zhu, Xian Li, Jiachao Ji, Juming Lu, Weiping Jia, et al. (2019). Cost Change After Initiating Basal Insulin for 6 Months in Patients with Type 2 Diabetes: A Registry Study in China. International Journal of Diabetes and Endocrinology, 4(3), 62-72. https://doi.org/10.11648/j.ijde.20190403.11

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ACS Style

Dongshan Zhu; Xian Li; Jiachao Ji; Juming Lu; Weiping Jia, et al. Cost Change After Initiating Basal Insulin for 6 Months in Patients with Type 2 Diabetes: A Registry Study in China. Int. J. Diabetes Endocrinol. 2019, 4(3), 62-72. doi: 10.11648/j.ijde.20190403.11

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AMA Style

Dongshan Zhu, Xian Li, Jiachao Ji, Juming Lu, Weiping Jia, et al. Cost Change After Initiating Basal Insulin for 6 Months in Patients with Type 2 Diabetes: A Registry Study in China. Int J Diabetes Endocrinol. 2019;4(3):62-72. doi: 10.11648/j.ijde.20190403.11

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@article{10.11648/j.ijde.20190403.11,
  author = {Dongshan Zhu and Xian Li and Jiachao Ji and Juming Lu and Weiping Jia and Linong Ji and Puhong Zhang},
  title = {Cost Change After Initiating Basal Insulin for 6 Months in Patients with Type 2 Diabetes: A Registry Study in China},
  journal = {International Journal of Diabetes and Endocrinology},
  volume = {4},
  number = {3},
  pages = {62-72},
  doi = {10.11648/j.ijde.20190403.11},
  url = {https://doi.org/10.11648/j.ijde.20190403.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijde.20190403.11},
  abstract = {This study aims to examine short-term treatment cost changes after initiating basal insulin in insulin naïve patients with type 2 diabetes for 6 months in routine clinical practice. Observational Registry of Basal Insulin Treatment (ORBIT) program is a 6-month, prospective study in China. Patients with type 2 diabetes inadequately controlled (HbA1C≥7%) by oral antidiabetic drugs (OADs) and willing to initiate basal insulin treatment were enrolled from 209 hospitals of eight geographic regions of China. Type and dose of BI were at the physician’s discretion and patients’ willingness. Interviews were conducted at baseline, month 3 and month 6. Daily treatment cost (including cost of OAD medication, insulin therapy, self-monitoring of blood glucose and dealing with minor hypoglycemia) of per person before and after adding BIs was evaluated. After adding on Basal insulin, the weighted mean ± standard deviation (SD) daily treatment cost for insulin-naïve patients with type 2 diabetes increased from $1.25 ± $0.74 (baseline) to $2.57 ± $0.68 at month 6, a median (Q1, Q3) increase of 1.51 (0.38, 4.11) times over 6 months. The daily treatment cost increased with growing baseline HbA1c level and prolonged diabetes duration. The reduction in HbA1c was 2.2%, with minor hypoglycemia increased by 0.68 times/person/year. Insulin cost accounted for the highest proportion (47.9%) of costs. Our findings suggest adding-on BI therapy may increase the daily treatment cost by 1.5 times at 6 months. Early initiation of BI therapy may provide an opportunity to achieve treatment goals with low cost and low risk of hypoglycemia.},
 year = {2019}
}

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TY - JOUR
T1 - Cost Change After Initiating Basal Insulin for 6 Months in Patients with Type 2 Diabetes: A Registry Study in China
AU - Dongshan Zhu
AU - Xian Li
AU - Jiachao Ji
AU - Juming Lu
AU - Weiping Jia
AU - Linong Ji
AU - Puhong Zhang
Y1 - 2019/09/03
PY - 2019
N1 - https://doi.org/10.11648/j.ijde.20190403.11
DO - 10.11648/j.ijde.20190403.11
T2 - International Journal of Diabetes and Endocrinology
JF - International Journal of Diabetes and Endocrinology
JO - International Journal of Diabetes and Endocrinology
SP - 62
EP - 72
PB - Science Publishing Group
SN - 2640-1371
UR - https://doi.org/10.11648/j.ijde.20190403.11
AB - This study aims to examine short-term treatment cost changes after initiating basal insulin in insulin naïve patients with type 2 diabetes for 6 months in routine clinical practice. Observational Registry of Basal Insulin Treatment (ORBIT) program is a 6-month, prospective study in China. Patients with type 2 diabetes inadequately controlled (HbA1C≥7%) by oral antidiabetic drugs (OADs) and willing to initiate basal insulin treatment were enrolled from 209 hospitals of eight geographic regions of China. Type and dose of BI were at the physician’s discretion and patients’ willingness. Interviews were conducted at baseline, month 3 and month 6. Daily treatment cost (including cost of OAD medication, insulin therapy, self-monitoring of blood glucose and dealing with minor hypoglycemia) of per person before and after adding BIs was evaluated. After adding on Basal insulin, the weighted mean ± standard deviation (SD) daily treatment cost for insulin-naïve patients with type 2 diabetes increased from $1.25 ± $0.74 (baseline) to $2.57 ± $0.68 at month 6, a median (Q1, Q3) increase of 1.51 (0.38, 4.11) times over 6 months. The daily treatment cost increased with growing baseline HbA1c level and prolonged diabetes duration. The reduction in HbA1c was 2.2%, with minor hypoglycemia increased by 0.68 times/person/year. Insulin cost accounted for the highest proportion (47.9%) of costs. Our findings suggest adding-on BI therapy may increase the daily treatment cost by 1.5 times at 6 months. Early initiation of BI therapy may provide an opportunity to achieve treatment goals with low cost and low risk of hypoglycemia.
VL - 4
IS - 3
ER -

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Author Information

Dongshan Zhu

Diabetes Research Program, The George Institute for Global Health at Peking University Health Science Center, Beijing, P. R. China
Xian Li

Biostatistics & Economic Evaluation Program, The George Institute for Global Health at Peking University Health Science Center, Beijing, P. R. China
Jiachao Ji

Biostatistics & Economic Evaluation Program, The George Institute for Global Health at Peking University Health Science Center, Beijing, P. R. China
Juming Lu

Department of Endocrinology, The General Hospital of the People's Liberation Army, Beijing, P. R. China
Weiping Jia

Department of Endocrinology, Shanghai Sixth People’s Hospital, Shanghai, P. R. China
Linong Ji

Department of Endocrinology and Metabolism, Peking University People’s Hospital, Beijing, P. R. China
Puhong Zhang

Diabetes Research Program, The George Institute for Global Health at Peking University Health Science Center, Beijing, P. R. China

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APA Style

Dongshan Zhu, Xian Li, Jiachao Ji, Juming Lu, Weiping Jia, et al. (2019). Cost Change After Initiating Basal Insulin for 6 Months in Patients with Type 2 Diabetes: A Registry Study in China. International Journal of Diabetes and Endocrinology, 4(3), 62-72. https://doi.org/10.11648/j.ijde.20190403.11

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ACS Style

Dongshan Zhu; Xian Li; Jiachao Ji; Juming Lu; Weiping Jia, et al. Cost Change After Initiating Basal Insulin for 6 Months in Patients with Type 2 Diabetes: A Registry Study in China. Int. J. Diabetes Endocrinol. 2019, 4(3), 62-72. doi: 10.11648/j.ijde.20190403.11

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AMA Style

Dongshan Zhu, Xian Li, Jiachao Ji, Juming Lu, Weiping Jia, et al. Cost Change After Initiating Basal Insulin for 6 Months in Patients with Type 2 Diabetes: A Registry Study in China. Int J Diabetes Endocrinol. 2019;4(3):62-72. doi: 10.11648/j.ijde.20190403.11

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@article{10.11648/j.ijde.20190403.11,
  author = {Dongshan Zhu and Xian Li and Jiachao Ji and Juming Lu and Weiping Jia and Linong Ji and Puhong Zhang},
  title = {Cost Change After Initiating Basal Insulin for 6 Months in Patients with Type 2 Diabetes: A Registry Study in China},
  journal = {International Journal of Diabetes and Endocrinology},
  volume = {4},
  number = {3},
  pages = {62-72},
  doi = {10.11648/j.ijde.20190403.11},
  url = {https://doi.org/10.11648/j.ijde.20190403.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijde.20190403.11},
  abstract = {This study aims to examine short-term treatment cost changes after initiating basal insulin in insulin naïve patients with type 2 diabetes for 6 months in routine clinical practice. Observational Registry of Basal Insulin Treatment (ORBIT) program is a 6-month, prospective study in China. Patients with type 2 diabetes inadequately controlled (HbA1C≥7%) by oral antidiabetic drugs (OADs) and willing to initiate basal insulin treatment were enrolled from 209 hospitals of eight geographic regions of China. Type and dose of BI were at the physician’s discretion and patients’ willingness. Interviews were conducted at baseline, month 3 and month 6. Daily treatment cost (including cost of OAD medication, insulin therapy, self-monitoring of blood glucose and dealing with minor hypoglycemia) of per person before and after adding BIs was evaluated. After adding on Basal insulin, the weighted mean ± standard deviation (SD) daily treatment cost for insulin-naïve patients with type 2 diabetes increased from $1.25 ± $0.74 (baseline) to $2.57 ± $0.68 at month 6, a median (Q1, Q3) increase of 1.51 (0.38, 4.11) times over 6 months. The daily treatment cost increased with growing baseline HbA1c level and prolonged diabetes duration. The reduction in HbA1c was 2.2%, with minor hypoglycemia increased by 0.68 times/person/year. Insulin cost accounted for the highest proportion (47.9%) of costs. Our findings suggest adding-on BI therapy may increase the daily treatment cost by 1.5 times at 6 months. Early initiation of BI therapy may provide an opportunity to achieve treatment goals with low cost and low risk of hypoglycemia.},
 year = {2019}
}

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