Cost-Related Insulin Underuse Common, Associated With Poor Glycemic Control

Patients often report cost-related insulin underuse that is commonly associated with poor glycemic control, according to research presented at the 2018 78th ADA Scientific Sessions. 

Although insulin is an essential medicine for patients with diabetes, increasing prices have threatened its affordability. 

In order to examine the prevalence of and factors associated with cost-related insulin underuse, a research team, led by Kasia J Lipska, MD, assistant professor of medicine (Endocrinology) at Yale School of Medicine, and colleagues,
administered a cross-sectional survey to patients with diabetes prescribed insulin at Yale Diabetes Center. 

The primary study outcome was cost-related underuse in the past 12 months, and researchers also examined the association of cost-related underuse with HbA^1c >9% using logistic regression controlling for age, sex, age, diabetes duration, and income.

According to the findings, of the 354 patients prescribed insulin who completed the survey, 51 (25.5%) reported cost-related insulin underuse. 

Dr Lipska and colleagues noted that patients with cost-related underuse had lower income levels, variable drug coverage and
employment, and 3-fold higher odds of HbA^1c >9% (P = .03) than patients who did not report underuse.

“One in four patients at our urban diabetes center reported cost-related insulin underuse, and this was associated with poor glycemic control,” Dr Lipska and colleagues concluded. “These results highlight an urgent need to address high insulin prices in the United States.”

—Julie Gould