This article contains Supplementary Data online at http://care.diabetesjournals.org/lookup/suppl/doi:10.2337/dc18-1850/-/DC1. The study cohort was younger than the average individual with type 1 diabetes in the NDR (34 vs. 46 years), had a shorter duration of diabetes (21 vs. 24 years), and had a higher HbA1c (8.1 vs. 7.8% [65 vs. 62 mmol/mol]) at baseline. Thank you for your interest in spreading the word about Diabetes Care. The NDR includes ∼97% of all Swedish individuals with type 1 diabetes age 18 years and older. Insulin pumps, cartridges, and infusion sets may be far more expensive than syringes used for insulin injection. BMJ. Insulin pump therapy users were double-matched to 9,247 adults who used multiple injection therapy (mean age, 33.8 years; 51.3% women). © 2019 by the American Diabetes Association. 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. Therefore there should be no economical hindrance for the patient to be treated with insulin pump. 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. [1] recently published the data from a pragmatic randomized controlled trial (RCT) comparing the efficacy, safety and cost-effectiveness of insulin therapy delivered over a period of one year, either as continuous infusion (through a pump) or multiple daily injections, in children with newly diagnosed type 1 diabetes mellitus (T1DM). The remaining study years, including the year of switch, contributed to the insulin pump group for this individual. But if self funding, let's say 4 injections a day vs a pump. A Swedish health technology assessment review in 2013 did not find evidence for differences in severe hypoglycemia between pump therapy and MDI but identified indications of lower HbA1c (13). The results were robust to choice of matching and imputation strategy. 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. There were also more annual outpatient visits among pump users compared with multiple daily injection users (3.8 vs. 3.5; P < .001). Insulin pump costs . 4). 20 Years of Successful Improvements. What will be the outcome for today’s generation with type 1 diabetes onset in the post–DCCT era once intensive glucose-lowering therapy with MDI and pumps has been established as the standard for >20 years and patients have access to a wide range of modern devices for glucose control and medications? Regression analyses explored the role of sociodemographic factors. Without insurance, a new insulin pump costs about $6,000 out of pocket, plus another $3,000 to $6,000 annually for ongoing supplies, like batteries and sensors. 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). However, the cost increments for insulin pump therapy decreased with age (differences ranging from 56% for those 18–27 years of age to 44% for those ≥48 years [reference: MDI 18–27 years]). Mean age at baseline was 34 years, with 21 years of diabetes duration and a mean HbA1c of 8.1% (65 mmol/mol). All costs are indexed to 2013 values. We understand that trying to get an insulin pump can be very frustrating, and you might feel disappointed if you can’t get one. The researchers found that annual costs for adults who used insulin pump therapy were $3,923 more than those who used multiple daily injections (95% CI, 3,703-4,143). Clinically, insulin pens show an advantage through i … However, real-world data on health care and societal costs of insulin pump therapy compared with MDI therapy are scarce. For heavy insulin users, pumps were much less expensive at $28,826 versus $41,100 for injections. Insulin costs have soared from $100–$200 per month a few years ago to $400–$500 a month now. “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. Research design and methods: Individuals with type 1 diabetes and pump therapy in the Swedish National Diabetes Register (NDR) since 2002 were eligible. Total annual costs increased with age for both insulin therapies, and pump therapy was associated with higher costs across age-groups. Subgroup analyses revealed expected and substantial differences in average annual costs by diabetes duration and age (Fig. Subgroup analysis revealed that health care costs, both for pump therapy and multiple daily injections, were higher for women compared with men (P < .001), adults aged at least 48 years compared with younger adults (P < .001) and those with diabetes duration of 20 years or more compared with shorter duration (P < .001). Most people in the UK who have a pump have it funded by the NHS. Swedish National Diabetes Register. We obtained longitudinal health and socioeconomic data for 2005–2013 from the National Patient Register, National Prescribed Drug Register, National Cause of Death Register, and National Integrated Database for Labor Market Research. The cost of insulin pumps is often between £2000 and £3000. Cost of medications and disposables by Swedish pharmacy official retail prices were taken from the Swedish Prescribed Drug Register. Acknowledgments. Mean annual costs were higher for pump therapy than for MDI therapy ($12,928 vs. $9,005, respectively; P < 0.001; mean difference $3,923 [95% CI $3,703–$4,143]). We selected two control subjects for each insulin pump user, defining the index date as the date of entry in the NDR for those with ongoing insulin pump therapy since childhood/adolescence or the first registration of insulin pump therapy in the NDR. 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. The ethical review board at the University of Gothenburg approved the study. We performed 13 subgroup analyses to evaluate the robustness of the estimates of level of costs and differences between treatment groups. Switch, contributed to the bloodstream via a catheter inserted under the skin women, increased age. Your health care and societal costs of insulin pump or MDI therapy are scarce stockholm, Sweden Statistika! 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