title: Does pen help? A real-world outcomes study of switching from vial to disposable pen among insulin glargine-treated patients with type 2 diabetes mellitus.
abstract: OBJECTIVE
  The study was designed to evaluate real-world data on clinical and economic outcome differences between patients with type 2 diabetes mellitus (T2DM) who use insulin glargine with vial-and-syringe delivery and those who switch to pen administration.
  
  
  METHODS
  This retrospective study analyzed medical and pharmacy claims information from the national managed-care IMPACT(®) database (Ingenix Inc., Salt Lake City, UT). Adults with T2DM treated with insulin glargine were evaluated. Clinical and economic outcomes over 1 year were compared between individuals who had converted from administering glargine via vial-and-syringe to the SoloSTAR(®) (sanofi-aventis U.S., Bridgewater, NJ) pen (Switchers) and patients who continued to use vial-and-syringe administration (Continuers). Patients from each cohort were matched using propensity score matching for a comparison sample.
  
  
  RESULTS
  In total, 3,893 eligible patients were identified (665 Switchers and 3,228 Continuers), with a matched cohort with 603 patients in each group. Baseline characteristics were similar between groups. One-year treatment persistence was significantly higher with Switchers versus Continuers (65.3% vs. 49.8%; P<0.0001). Medication possession ratio was also significantly higher among Switchers (0.79 vs. 0.76; P=0.0173). Insulin use and glycemic control were similar between groups. Healthcare utilization and total costs were also similar between groups. Higher prescription costs among Switchers were offset by lower overall and diabetes-related outpatient and inpatient costs.
  
  
  CONCLUSIONS
  Switching from insulin glargine vial-and-syringe administration to pen delivery resulted in improved treatment adherence and persistence, with comparable clinical and economic outcomes.
authors: STATinMED Research, Inc., Ann Arbor, MI, USA.
authors: Lin
authors: L
authors: Xie
authors: Steve
authors: S
authors: Zhou
authors: Wenhui
authors: W
authors: Wei
authors: Jasvinder
authors: J
authors: Gill
authors: Chunshen
authors: C
authors: Pan
authors: Onur
authors: O
authors: Baser
mesh_terms: D001007:Anxiety; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000523:psychology; D004209:Disposable Equipment; D016503:Drug Delivery Systems / Q000523:psychology; D054796:Drug Dosage Calculations; D004867:Equipment Design; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007279:Injections, Subcutaneous / Q000009:adverse effects / Q000523:psychology; D000069036:Insulin Glargine; D049528:Insulin, Long-Acting / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000523:psychology; D057240:Patient Preference / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013594:Syringes / Q000009:adverse effects; D016903:Drug Monitoring
chemical_list: D007004:Hypoglycemic Agents; D049528:Insulin, Long-Acting; D000069036:Insulin Glargine