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

Abstract

This study aims to examine short-term treatment cost changes after initiating basal insulin in insulin naive 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-naive 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.