Comparing Insulin Pen versus Vial Use in the Elderly Medicare Part D Population for Long-Acting Basal Insulin Adherence

by Steven A. Blackwell, PhD, JD | Gerald F. Riley, MSPH

June 8, 2017


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Summary:

The primary aim of this study was to determine whether pens result in improved adherence for long-acting basal insulin administration as compared with vials in elderly Medicare patients.



Abstract:

Our study aimed to: (1) determine whether insulin pens result in improved adherence for long-acting basal insulin administration as compared with vials in elderly Medicare patients; and (2) identify characteristics associated with adherence for long-acting basal insulin. The cross-sectional study examined Medicare beneficiaries over age 65 with type 1 or type 2 diabetes during calendar years 2008 and 2010. We found that: (1) insulin pen use was not associated with higher adherence compared with vial use for long-acting basal insulin; (2) improved adherence was found among dual enrollees as compared with non-dual enrollees and those newly diagnosed with diabetes as compared with those currently with diabetes; and (3) the eldest elderly (age 85 and over) were less adherent than their younger counterparts. We concluded that pen use with long-acting basal insulin does not lead to improved adherence among elderly Medicare beneficiaries.


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Steven A. Blackwell, PhD, JD

Centers for Medicare & Medicaid Services, 7500 Security Boulevard, Mail Stop: WB-06-05, Baltimore, MD 21244-1850; phone: 410-786-6852; e-mail: sblackwell@cms.hhs.gov.


Gerald F. Riley, MSPH

Retired from Centers for Medicare & Medicaid Services; Columbia, Maryland.

For over 45 years.

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