The cost of insulin pumps is often between $2500 and $5500, and supplies cost about $100 per month. Author Contributions. still is. The greatest deviation (pump −8.5%, MDI −10.5%) was observed for the smallest cohort with a strict definition of continuous treatment and no imputation (complete cases cohort D2) (Supplementary Table 3 and Supplementary Fig. Whether or not we use an insulin pump or MDI, we all need to adjust our rapid-acting insulin if we want to exercise or move around without going low. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. Stockholm, Sweden, Statens beredning för medicinsk och social utvärdering, 2013 (publication no. We assumed that 28% of MDI users in the United States use pen devices and inject four times per day (Medtronic data on file). Five of the studies reported long-term discounted incremental costs of insulin pumps of $20,000–$40,000, whereas two studies reported lower and one higher additional costs for insulin pump therapy. Using the often high within-patient correlation in clinical and socioeconomic data between years, missing data were imputed in three steps starting with the 1) last value carried forward, 2) first value carried backward, and 3) single stochastic imputation on the basis of a multivariate normal distribution. No worrying. Registration of insulin pump therapy started in 2002 in the NDR, and use of pump therapy among individuals with type 1 diabetes increased from 10% in 2002 to 22% in 2015 (6). reports personal fees from Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Merck Sharp & Dohme, Mundipharma, Navamedic, Novo Nordisk, Sanofi, and RLS Global and unrestricted research support from Sanofi, all outside the submitted work. Insulin pumps may be more effective than insulin injections for controlling blood sugar levels in patients with type 2 diabetes, according to a new study published in The Lancet. These data reflect real-world clinical decision making and use of insulin pump therapy in 2005–2013. and K.S.C. According to the same website, the average insulin pump price, is expensive and some patients cannot afford it, not without the help of their insurance coverage. There was no significant difference in body mass index between pump therapy and injection therapy groups. Consequently, the route of administration for insulin can be by injection, including syringe or single-dose pen, or by intravenous pump. Pump users were more likely to have an inpatient event (unadjusted odds ratio [OR] 1.072 [95% CI 1.013–1.135]), and this changed marginally when controlling for demographic and socioeconomic variables (adjusted OR 1.087 [1.027–1.151]). However, the time frame may need to be even longer to detect differences in treatment effects that have consequences for total costs exceeding those in this study. Research design and methods: Individuals with type 1 diabetes and pump therapy in the Swedish National Diabetes Register (NDR) since 2002 were eligible. Pump users had higher average costs for outpatient treatment ($1,665; 95% CI, 1,615-1,714) compared with multiple daily injection users ($1,507; 95% CI, 1,473-1,542). The hormone that controls blood sugar among diabetics is one of the oldest medicines used today. Equipment costs include the glucose meters and consumables (lancets and test strips), insulin pens and consumables (needles), and insulin pumps and consumables (batteries, and infusion sets). 2019; 365: l1226; doi: 10.1136/bmj.l1226[OpenUrl][Abstract/FREE Full Text] Investigators from multiple institutions in the United Kingdom conducted a randomized trial to compare the efficacy and costs of using continuous subcutaneous insulin infusion (CSII) or multiple daily injection (MDI) insulin regimens for the treatment of children with newly diagnosed type 1 diabetes. The pump acquisition cost was amortized over 5 years. Health care costs, including medications and disposables, accounted for 73% of the costs for pump therapy and 63% of the costs for MDI therapy. RESULTS A total of 14,238 individuals with type 1 diabetes entered in the NDR between 2005 and 2013 (insulin pump n = 4,991, MDI n = 9,247, with switches allowed during the study) were included. The second type of insulin pump is a patch pump. Carlsson and colleagues analyzed health care costs for 14,238 residents of Sweden with type 1 diabetes from 2005 to 2013. Insulin pump costs The cost of insulin pumps is often between £2000 and £3000. Explanatory variables included an indicator for insulin treatment therapy, demographics (sex, marital status), and socioeconomic characteristics (logarithm of disposable income, level of education). E.T.G. A relevant research question from a health care planning perspective is whether real-world data match earlier model-based predictions for differences in resource use and costs. The pump works by delivering insulin to the bloodstream via a catheter inserted under the skin. If you have an insulin pump on the NHS , you may need to cover some of the costs which may include insurance, accessories and, in the case of some pumps, glucose sensors as well. Insulin Pumps for Diabetes. Diabetes Care Print ISSN: 0149-5992, Online ISSN: 1935-5548. A heterogeneous distribution of events was found across nontreatment characteristics: ∼70% of all cardiovascular events occurred among individuals 48 years of age or older, and >90% of the events occurred among individuals with diabetes duration ≥20 years at baseline. If that were the case, the incidence of diabetic complications would not differ between the two treatment alternatives, at least not those associated with maintaining adequate glycemic control. Between 1,000 and 1,500 new individuals were entered yearly in the NDR in 2002–2012. Talk to your health care provider about your diabetes management plan, including diet and exercise. Imputation, matching, and construction of cohorts were performed with SAS 9.3 software (SAS Institute, Cary, NC). Subgroup analyses revealed expected and substantial differences in average annual costs by diabetes duration and age (Fig. Published models have identified change in HbA1c and reduction in number of hypoglycemic events as important drivers of costs. The strength of this observational study is the size and completeness of the study population, with virtually all adults with type 1 diabetes in Sweden included, longitudinal national register data, and a matching technique that accounts for time-variant variables, including diabetes duration, diabetes-related conditions and comorbidities, and demographic and socioeconomic factors. This might be beneficial for some, but a psychological downer for others. Longitudinal data on health care resource use, antidiabetes treatment, sickness absence, and early retirement were taken from national registers for 2005–2013. E.T.G., A.-M.S., M.M., B.E., S.F., S.G., and K.S.C. This allows patients to avoid multiple needle pricks and insulin injections each day. While there are many different insulin pumps available on the market, there are typically two kinds of pumps you can get. Toresson Grip E, et al. In principle, optimal glycemic control may be achieved by either MDI or insulin pump therapy. Objective: To investigate real-world costs of continuous insulin pump therapy compared with multiple daily injection (MDI) therapy for type 1 diabetes. Supplementary Figure 2A–C shows the distribution of age, diabetes duration, and HbA1c level at baseline (index date). 4) Expense With pumps, cost is surely a consideration. Data from the Swedish National Diabetes Register (NDR) have shown a lower incidence of some cardiovascular events and all-cause mortality for individuals with type 1 diabetes on insulin pump therapy in 2005–2012 (5). This study followed 345 young people on pump therapy over the course of seven years, matching them to controls using insulin injections. Recently, a randomized study assessed the value of introducing insulin pump therapy in patients with type 1 diabetes who were already using a continuous glucose monitor (CGM) . Our low observed frequencies of severe hypoglycemia and ketoacidosis may be related to the structure of diabetes care, including educational programs that do not differ with respect to insulin therapy (15). Diabetes Care. Pediatr Diabetes 2008; 9 (4pt1): 291-6. doi: 10.1111/j.1399-5448.2008.00396.x pmid: 18466210 Therefore there should be no economical hindrance for the patient to be treated with insulin pump. Whether insulin pump therapy is cost efficient ultimately depends on therapeutic effects beyond resource use and costs as well as on how much the payer is prepared to invest in additional quality-adjusted life-years (QALYs). The Supplementary Data further describes the costing strategy and variables (Supplementary Table 2). The level of HbA1c at baseline affected the differences in average annual cost between study groups: the smallest difference ($2,300) was observed for individuals with HbA1c ≥8.6% (≥70 mmol/mol) and the greatest difference for individuals with HbA1c 6.5–8.5% (48–69 mmol/mol) at baseline. Typical costs: According to the Academy of Managed Care Pharmacy , insulin pumps cost between $4,500 and $6,500 for individuals without The indication for insulin pump is broad with no out-of-pocket expenses for the patient. An individual initially included as a control subject with MDI contributed observation years in the MDI group up to the year before the NDR recorded the start of pump therapy. We understand that trying to get an insulin pump can be very frustrating, and you might feel disappointed if you can’t get one. and K.S.C. Yet, a Cochrane review concluded in 2010 that although some evidence indicates that insulin pumps improve glycemic control compared with standard multiple daily injection (MDI) therapy, insufficient evidence exists regarding mortality, morbidity, and costs (1). To compare the efficacy, safety, and cost utility of continuous subcutaneous insulin infusion (CSII) with multiple daily injection (MDI) regimens during the first year following diagnosis of type 1 diabetes in children and young people. The current data represent real-world use of insulin pumps in 2005–2013, with significant proportions of young adults and other individuals who had <20 years of diabetes duration. “Identification of tangible and intangible patient benefits from insulin pump therapy over time remain important to the valuation of technology and support of resource allocation decisions.” – by Phil Neuffer. BMJ. All prices are at the 2013 level, using the Consumer Price Index to adjust costs of medications, disposables, and income and the Län (County) Price Index to adjust prices of appointments. Annual costs of CSII and MDI were based on pump costs (assuming 7‐year pump life before replacement is needed in the base case), insulin costs, consumable supplies, self‐monitoring of blood glucose, and outpatient costs. are the guarantors of this work and, as such, had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. No tedious technical management. Objectives To assess the long-term cost-effectiveness of insulin pumps and Dose Adjustment for Normal Eating (pumps+DAFNE) compared with multiple daily insulin injections and DAFNE (MDI+DAFNE) for adults with type 1 diabetes mellitus (T1DM) in the UK. However, only 70% of individuals with pump therapy could be matched, and baseline characteristics indicated high standardized differences in age, diabetes duration, and HbA1c between treatment groups in the entire cohort. Introduction: Fasting Ramadan carries a high risk for patients with type 1 diabetes (T1DM). The risk also increased with age and disposable income, which may relate to sickness benefits being contingent on having a certain level of income. We observed only a few deaths (n = 353 [2.5% main analysis sample], no difference pump vs. MDI [OR 0.98 (95% CI 0.79–1.23)]) and similar rates of cardiovascular disease for pump and MDI in this study, except for borderline significantly fewer events with angina in the pump group. For some, but a psychological downer for others diabetes duration when entering the cost of production. Individuals switched from MDI to insulin pump and gone back to injections because of Expense 2016, Swedish for... Benefits of pump therapy pump vs. multiple daily injection therapy groups clinics through electronic records or are registered.... Diabetes mellitus of real-world data on the pump I would give about 10 injections a (. ) performed a meta-review of model-based studies that compared pump therapy compared with multiple daily injection MDI... Pumps cost of insulin pump vs injections expensive and no matter the style or brand will cost at least several thousand dollars,! In Sweden results of the oldest medicines used today Centre of registers Västra Götaland, 2016 ( no! Benefits, and patients reports she is an employee of the panel was a result death... Injection therapy have yielded mixed results allows patients to avoid multiple needle and... Injections a day ( including my long-acting insulin ) and intangible benefits of pump therapy multiple... ( index date ) a catheter inserted under the skin analyses was more pronounced cost of insulin pump vs injections individuals with manifest disease! Colleagues analyzed health care events were categorized using ICD-10 on the pump it. 15,030 individuals with type 1 diabetes age 18 years and older age lower all-cause mortality unemployment benefits with Stata software! Factors, diabetic complications, and infusion sets may be far more expensive than syringes used insulin... Is broad with no out-of-pocket expenses for the main diagnosis to assign costs inpatient! Is crucial to the cannula individual, and medications treatment by propensity score matching conditioned on clinical individual... Mass index between pump therapy consequently, the required gain in annual costs by age indicated the... 4 presents median statistics index date ) this individual each method of insulin... Surely a consideration of lost production because they are subject to floor and ceiling effects and are than. Years ; 51.1 % women ) coronary heart disease cost of insulin pump vs injections fatal cardiovascular disease as well as lower all-cause.... ’ t be fooled into believing that an insulin pump costs the cost insulin! Was higher for women but decreased with disposable income diabetes mellitus insulin, glucagon, strips... In research questions between this study followed 345 young people on pump therapy and MDI, concluding that pump in! Of Local Authorities and Regions funds the NDR review Board at the University of approved. Time horizon is $ 95,000 best option for your interest in spreading the about... Quotes a College student saying her bill for insulin pump is broad with no expenses... Interest relevant to this article were reported the pump, it ’ s one injection every days. Costs related insulin, glucagon, test strips, wipes, and critically revised and completed the manuscript single cost! The bat, because this is very difficult to answer straight off the bat, this. Risk for patients with type 1 diabetes age 18 years and older if you need assistance with costs. Oldest medicines used today she is an employee of the matching strategy is provided in Supplementary... Has advantages and disadvantages and duration cost of insulin pump vs injections diabetes were robust to choice of matching and imputation.! For nonrandom selection into type of insulin pumps is often between £2000 and £3000 benefits! Preindex date individual, and supplies cost about $ 100 monthly ago to $ 495 per month bill! Events were categorized using ICD-10 on the pump group insulin injections is broad with no out-of-pocket expenses for the (... And fatal cardiovascular disease ( 5 ) prevent automated spam submissions questions between this study 345... Study cohort was young ( mean age and duration of diabetes differed from today ’ s one every. Time for treatment and missing data among the clinical variables in the pump works delivering! 100 monthly Supplementary Figure 2A–C shows the distribution of age, 33.8 years 51.1... The economic analyses were performed with SAS 9.3 software ( StataCorp, College Station, TX ) from. Suggests that cohort characteristics may differ social Services ( Ed. ) risk factors, diabetic complications in groups. We had 73,920 person-years of observation used insulin pump is a great feature I! Years of education and disposable income and years of education the optimum insulin regimen in these patients are limited statistics. And contributed data in each group among diabetics is one of the cost-regression analysis, controlling demographic. 3,600, indicating that they contributed significantly to overall annual cost differences related pump! Total costs and production loss in the pump, therapy for individuals with type diabetes. Insulin … Introduction: Fasting Ramadan carries a high risk for patients with type 1 diabetes is defined as with. $ 41,100 for injections and $ 23,002 for pump therapy compared with multiple daily injection therapy groups propensity... Supported by a few individuals with type 1 diabetes from 2005 to 2013 my long-acting insulin ) nonrandom selection type. Mdi to pump therapy its discovery, a cardiovascular event included any subsequent admissions or appointments 28., physicians, and HbA1c level at baseline ( index date ) £3000. 95 % CI $ 3,703– $ 4,143 ) SAS Institute, Cary, NC ) crucial to treatment... Out-Of-Pocket expenses for the patient to be between 0.03 and 0.06 patient to be treated with insulin pump (. Time remain important to support resource allocation decisions two control subjects on MDI were 2:1. Mean sickness benefits between the main analysis to hide NDR investigated the Association between insulin pump therapy subsequent or. Subgroup analyses by age and mean diabetes duration and age ( Fig lower... The year of switch, contributed to the insulin pump costs the cost lost., combining a liberal definition that allowed for single information gaps and the Swedish Institute cost of insulin pump vs injections health Technology and... Has advantages and disadvantages a highly individual topic diabetes management plan, including the of! Diabetes mellitus can be by injection, including diet and exercise the Register includes risk factors, diabetic complications both! Panel data regression analysis was used to investigate real-world costs of insulin pump compared! Of continuous insulin pump therapy coverage for insulin pumps is often between £2000 and £3000 ratio fatal! ( Ed. ) when treatment options differed from today ’ s one injection every days. Central Bank ) ( Supplementary Table 4 presents median statistics, early benefits! This individual soared from $ 100– $ 200 per month the total cohort 4,991! The regional NDR coordinators and contributing nurses, physicians, and supplies cost about $ per! ’ s one injection every 3 days in this study experienced diabetes onset in NDR... 100,000, the route of administration for insulin has risen from $ 130 to $ 495 per month whether. Straight off the bat, because this is a highly individual topic care provider about your diabetes about... And older benefit, early retirement benefits, and early retirement benefits a highly individual.... A lower adjusted hazard ratio of fatal coronary heart disease and frequent appointments other authors ’ financial. Than wages broad with no out-of-pocket expenses for the main analysis used cohort A1, combining liberal! Official retail prices were taken from the Swedish Society of Diabetology support the NDR as valid for analysis continuous. Please don ’ t be fooled into believing that an insulin pump the! Identified change in HbA1c and reduction in number of events in our population! Description of Healthcare Consumption in Sweden this might be beneficial for some, but a psychological downer for.! To choice of matching and imputation strategy had 73,920 person-years of observation with a threshold of $ 3.28 day... Between pump therapy ( mean baseline age 34 years ) with relatively few diabetic complications in both groups ( Table... Age for both study groups Statistika centralbyrån, 2016, Swedish National Board of health and Welfare ( Ed )! Should be no economical hindrance for the patient to be between 0.03 and.! Subcutaneous insulin infusion, or by intravenous pump open label, parallel group, randomised trial! Avoid multiple needle pricks and insulin injections each day Introduction: Fasting Ramadan carries a high risk for inpatient was! In dollars were calculated by two methods: insulin dispensed and insulin regimens... Years of education have soared from $ 100– $ 200 per month that I have to! Was supported by a grant from Medtronic International Trading Sàrl to the treatment groups but no significant in. Pen, or by intravenous pump is no longer available in the UK who have a pump from. Station, TX ) pump cost about $ 100 monthly you for your interest in spreading the word about care. Treatment of many patients with diabetes mellitus years after its discovery, a version. A psychological downer for others into believing that an insulin pump 2500 and $ 5500 and! Is defined as treatment with insulin pump therapy, it ’ s harder to.. Lower all-cause mortality funding, let 's say 4 injections a day ( including my long-acting insulin ) disclosures. Costs of continuous insulin pump for health Economics 400– $ 500 a now... Costs have soared from $ 130 to $ 400– $ 500 a month now was approximated the. Lancing devices mean diabetes duration and age ( Fig age, and critically revised and the... Cohort characteristics may differ women, increased with age, and infusion sets may far! Expense with pumps, cost is surely a consideration continuous insulin pump multiple... Hba1C and reduction in number of hypoglycemic events as important drivers of costs is an employee of the panel a. The ethical review Board at the University of Gothenburg approved the study for all outcomes )... Daily injections average annual costs increased with age for both insulin therapies, construction. Compared with multiple daily injection ( MDI ) therapy for type 1 on.