Rising cost of insulin: A deterrent to compliance in patients with diabetes mellitus.


Journal

Diabetes & metabolic syndrome
ISSN: 1878-0334
Titre abrégé: Diabetes Metab Syndr
Pays: Netherlands
ID NLM: 101462250

Informations de publication

Date de publication:
Aug 2022
Historique:
received: 27 11 2021
revised: 24 05 2022
accepted: 25 05 2022
pubmed: 22 7 2022
medline: 31 8 2022
entrez: 21 7 2022
Statut: ppublish

Résumé

The rapid increase in burden of type 2 diabetes mellitus (T2DM), poses a huge medico-economic challenge, especially when the cost of care is funded by out-of-pocket expenses. The aim of this review is to highlight various issues associated with rising cost of insulin, prevalence of cost-related insulin underuse, insulin related cost-saving behaviors, and viable solutions for the benefit of patients with T2DM receiving insulin. Electronic databases (PubMed and Google Scholar) from 2000 to 2020 were searched using the key terms uncontrolled diabetes mellitus, insulin therapy, glycemic control, direct cost, indirect cost, out-of-pocket expenses, cost-related insulin underuse, cost-saving behaviors, and biosimilar insulin in developed countries and India. In majority of the patients with T2DM on monotherapy, addition of another oral antidiabetic agent is required. Despite these measures, the target glycemic goals are not achieved in majority of the patients resulting in various complications. These complications can be prevented and target glycemic goals can be achieved with early initiation of insulin therapy. However, rising cost is a major deterrent to the lifelong use of insulin. This results in non-compliance and further deterioration of glycemic control. Recently, biosimilar insulins have revolutionized the management of T2DM and look promising from the economic point of view. Biosimilar insulins are likely to further enhance the compliance of patients and should be used whenever feasible in patients with DM. However, the patient, along with prescriber should be allowed to make shared, informed decisions regarding the insulin they wish to use.

Sections du résumé

BACKGROUND AND AIMS OBJECTIVE
The rapid increase in burden of type 2 diabetes mellitus (T2DM), poses a huge medico-economic challenge, especially when the cost of care is funded by out-of-pocket expenses. The aim of this review is to highlight various issues associated with rising cost of insulin, prevalence of cost-related insulin underuse, insulin related cost-saving behaviors, and viable solutions for the benefit of patients with T2DM receiving insulin.
METHODS METHODS
Electronic databases (PubMed and Google Scholar) from 2000 to 2020 were searched using the key terms uncontrolled diabetes mellitus, insulin therapy, glycemic control, direct cost, indirect cost, out-of-pocket expenses, cost-related insulin underuse, cost-saving behaviors, and biosimilar insulin in developed countries and India.
RESULTS RESULTS
In majority of the patients with T2DM on monotherapy, addition of another oral antidiabetic agent is required. Despite these measures, the target glycemic goals are not achieved in majority of the patients resulting in various complications. These complications can be prevented and target glycemic goals can be achieved with early initiation of insulin therapy. However, rising cost is a major deterrent to the lifelong use of insulin. This results in non-compliance and further deterioration of glycemic control. Recently, biosimilar insulins have revolutionized the management of T2DM and look promising from the economic point of view.
CONCLUSIONS CONCLUSIONS
Biosimilar insulins are likely to further enhance the compliance of patients and should be used whenever feasible in patients with DM. However, the patient, along with prescriber should be allowed to make shared, informed decisions regarding the insulin they wish to use.

Identifiants

pubmed: 35863268
pii: S1871-4021(22)00142-4
doi: 10.1016/j.dsx.2022.102528
pii:
doi:

Substances chimiques

Biosimilar Pharmaceuticals 0
Blood Glucose 0
Hypoglycemic Agents 0
Insulin 0
Insulins 0

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

102528

Informations de copyright

Copyright © 2022. Published by Elsevier Ltd.

Déclaration de conflit d'intérêts

Declaration of competing interest Dr. Shahu Ingole and Dr. Sanjay Kamble are the employees of Wockhardt Ltd. (India). All other authors declare no conflict of interest.

Auteurs

Abdul Hamid Zargar (AH)

Centre for Diabetes and Endocrine Care, Gulshan Nagar, Chanpora, Srinagar, 190015, Jammu and Kashmir, India. Electronic address: zargarah@gmail.com.

Sanjay Kalra (S)

Bharati Hospital, Karnal, 132001, Haryana, India. Electronic address: brideknl@gmail.com.

Prasanna Kumar K M (PK)

Centre for Diabetes & Endocrine Care & Diabetacare, Kalyan Nagar Post, Bangalore, 560043, Karnataka, India. Electronic address: dr.kmpk@gmail.com.

Sreenivasa Murthy (S)

Lifecare Hospital and Research Centre, Sahakaranagara, Bangalore, 560092, Karnataka, India. Electronic address: drsreenivasamurthy@gmail.com.

Vijay Negalur (V)

Dr Negalur's Diabetes & Thyroid Specialty Centre, Gloria Chambers, Thane, 400603, Maharashtra, India. Electronic address: negalurvijay@gmail.com.

Rajesh Rajput (R)

Department of Endocrinology, PGIMS Rohtak, Rohtak, 124001, Haryana, India. Electronic address: drrajeshrajput@outlook.com.

Ashu Rastogi (A)

Department of Endocrinology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India. Electronic address: ashuendo@gmail.com.

Banshi Saboo (B)

Dia Care (Diabetes Care & Hormone Clinic), Department of Diabetology, Near Nehru Nagar Circle, Ahmedabad, Gujrat, India. Electronic address: banshisaboo@hotmail.com.

Surendra Kumar Sharma (SK)

Diabetes Thyroid and Endocrine Centre, Sodala, Jaipur, 302006, Rajasthan, India. Electronic address: sksharma7@gmail.com.

Rakesh Sahay (R)

Department of Endocrinology, Osmania Medical College, Hyderabad, 500095, Telangana, India. Electronic address: sahayrk@gmail.com.

S R Aravind (SR)

Diacon Hospital, Rajajinagar, Bangalore, 560019, Karnataka, India. Electronic address: draravind@hotmail.com.

Shehla Shaikh (S)

K.G.N. Clinic, Patel Arcade, Nagpada Junction, Mumbai, 400008, Maharashtra, India. Electronic address: drshehla@rediffmail.com.

Mangesh Tiwaskar (M)

Department of Medicine, Shilpa Medical Research Centre, Dahisar East, Mumbai, 400068, Maharashtra, India. Electronic address: tiwaskar@gmail.com.

Shahu Ingole (S)

Department of Medical Affairs, Wockhardt Towers Bandra Kurla Complex, Bandra (East), Mumbai, 400051, Maharashtra, India. Electronic address: singole@wockhardt.com.

Sanjay Kamble (S)

Department of Medical Affairs, Wockhardt Towers Bandra Kurla Complex, Bandra (East), Mumbai, 400051, Maharashtra, India. Electronic address: skamble@wockhardt.com.

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Classifications MeSH