Economic Evaluation of Continuous Subcutaneous Insulin Infusion for Children with Diabetes—Part II

Abstract

The aim of this study is to assess long-term metabolic outcomes in children with diabetes mellitus and to compare the efficacy, feasibility and metabolic control expenses for treatment with continuous subcutaneous insulin infusion (CSII), compared to human insulin treatment. The study sample included 34 children aged 3 to 18 years with type 1 diabetes, 17 with continuous subcutaneous insulin infusion (CSII) therapy and 17 with standard treatment with human insulin. The study observed for the following variables: duration of the disease, diabetic control, HbA1c deviation scores; height and weight deviation and price of the treatment. Methods applied include meta-analyses in the published medical literature, pharmacoeconomic analysis and statistical analysis. From the 34 children with diabetes type 1 observed retrospectively during the period 1999-2012, 17 were on CSII (mean age 10 years, mean duration of the disease—7 years, average usage of CSII—3 years). The test stripes cost 533 Euro/year (1100 stripes per year) and their average cost according to the duration of the disease is 3779.45 Euro since diagnosis. The blood glucose monitoring system costs 20 Euro and for the duration of the disease—4.96 Euro per patient per year. The average improvement of HbA(1c) after the CSII introduction is 1.85, while after the application of human insulin—0.28. The treatment with CSII leads to significant improvement in glycemic control compared to the treatment with human insulin. The reduced HbA(1c) shows good diabetes management, from one point of view, and good quality of life—from another.

Share and Cite:

E. Petkova, V. Petkova, M. Konstantinova and G. Petrova, "Economic Evaluation of Continuous Subcutaneous Insulin Infusion for Children with Diabetes—Part II," Modern Economy, Vol. 4 No. 10A, 2013, pp. 9-13. doi: 10.4236/me.2013.410A002.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] A. Mosca, A. Lapolla and P. Gillery, “Glycemic Control in the Clinical Management of Diabetic Patients,” Clinical Chemistry and Laboratory Medicine, Vol. 51, No. 4, 2013, pp. 753-766.
http://dx.doi.org/10.1515/cclm-2012-0594
[2] N. Cohen, M. E. Minshall, L. Sharon-Nash, K. Zakrzewska, W. J. Valentine and A. J. Palmer, “Continuous Subcutaneous Insulin Infusion versus Multiple Daily Injections of Insulin: Economic Comparison in Adult and Adolescent Type 1 Diabetes Mellitus in Australia,” Pharmacoeconomics. Vol. 25, No. 10, 2007, pp. 881-897.
http://dx.doi.org/10.2165/00019053-200725100-00006
[3] M. Monami, C. Lamanna, N. Marchionni and E. Mannucci, “Continuous Subcutaneous Insulin Infusion versus Multiple Dailyinsulin Injections in Type 1 Diabetes: A Meta-Analysis,” Acta Diabetologica, Vol. 47, No. 1, 2010, pp. 77-81. http://dx.doi.org/10.1007/s00592-009-0132-5
[4] W. Tamborlane, K. Swan, K. Sikes, A. Steffen and S. Weinzimer, “The Renaissance of Insulin Pump Treatment in Childhood Type 1 Diabetes,” Reviews in Endocrine & Metabolic Disorders, Vol. 7, No. 3, 2006, pp. 205-213.
http://dx.doi.org/10.1007/s11154-006-9018-9
[5] G. Soltesz, C. C. Patterson and G. Dalquist, “EURODIAB Study Group Worldwide Childhood Type 1 Diabetes Incidence—What Can We Learn from Epidemiology?” Pediatric Diabetes, Vol. 8, Suppl. 6, 2007, pp. 6-14.
http://dx.doi.org/10.1111/j.1399-5448.2007.00280.x
[6] F. Carle, R. Gesuita, G. Bruno, G. V. Coppa, A. Falorni, R. Lorini, et al., “Diabetes Incidence in 0-to 14-Year Age-Group in Italy,” Diabetes Care, Vol. 27, No. 12, 2004, pp. 2790-2796.
http://dx.doi.org/10.2337/diacare.27.12.2790
[7] G Stipancic, L. La Grasta Sabolic, M. Sepec, A. Radica, V. Skrabic, S. Severinski and M. Tiljak, “Regional Differences in Incidence and Clinical Presentation of Type 1 Diabetes in Children Aged under 15 Years in Croatia,” Croatian Medical Journal, Vol. 53, No. 2, 2012, pp. 141-148. http://dx.doi.org/10.3325/cmj.2012.53.141
[8] L. Plotnik, et al., “Safety and Effectiveness of Insulin Pump Therapy in Children and Adolescents with Type 1 Diabetes,” Diabetes Care, Vol. 26, No. 4, 2003, pp. 1142-1146. http://dx.doi.org/10.2337/diacare.26.4.1142
[9] B. W. Bode, H. T. Sabbah, T. M. Gross, L. P. Fredrickson and P. C. Davidson, “Diabetes Management in the New Millennium Using Insulin Pump Therapy,” Diabetes/ Metabolism Research and Reviews, Vol. 18, No. S1, 2002, pp. S14-S20. http://dx.doi.org/10.1002/dmrr.205
[10] D. Wilson, et al., “A Two-Center Randomized Controlled Feasibility Trial of Insulin Pump Therapy in Young Children with Diabetes,” Diabetes Care, Vol. 28, No. 1, 2005, pp. 15-19. http://dx.doi.org/10.2337/diacare.28.1.15
[11] http://www.medtronic-diabetes.bg/
[12] http://www.nhif.bg
[13] O. Cohen, A. Korner, R. Chlup, C. S. Zoupas, A. K. Ragozin, K. Wudi, et al., “Improved Glycemic Control through Continuous Glucosesensor-Augmented Insulin Pump Therapy: Prospective Results from a Community and Academic Practice Patient Registry,” Journal of Diabetes Science and Technology, Vol. 3, No. 4, 2009, pp. 804-811.

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.