Impact of a pharmacist-driven insulin dispensing program in a management services organization

Abstract

Background

Insulin prices have tripled in the United States over the past decade. The affordability of insulin products may affect patient adherence and, as a result, glucose control. Providers may need to consider less expensive insulin options to improve patient outcomes.

Objective

This study aimed to evaluate the impact of a low-cost, in-office insulin dispensing program led by pharmacists in a management services organization on patient glucose control, adherence to routine laboratory tests, and patient satisfaction.

Methods

This multicenter, retrospective cohort study was conducted at 2 primary care clinics in South Florida. The primary outcome was the change in mean hemoglobin A1c (HbA1c) at baseline versus 6 months after insulin program enrollment. The secondary outcomes included mean HbA1c at baseline versus 12 months after insulin program enrollment, patient satisfaction evaluated with a survey, and adherence to routine laboratory tests, specifically HbA1c and urine albumin to creatinine ratio before and after enrollment.

Results

A total of 21 patients met inclusion criteria. The mean HbA1c before program enrollment was 9.4% compared with a mean HbA1c of 8.6% 6 months after enrollment (P = 0.058) and 8.4% 12 months after enrollment when available (P = 0.097). Of the 12 patients who completed the patient satisfaction survey, 11 (91.7%) agreed or strongly agreed that they were satisfied with pharmacist involvement in insulin management and planned to continue using the insulin program.

Conclusion

Among patients with type 2 diabetes enrolled in a low-cost, in-office insulin program, change in mean HbA1c after 6 and 12 months was not statistically significant.