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

Introduction 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 The purpose of this study is 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 labs, and patient satisfaction. Methods This multi-center, retrospective cohort study was conducted at two primary care clinics in South Florida. The primary outcome was the change in mean hemoglobin A1c (HbA1c) at baseline versus 6 months post-insulin program enrollment. The secondary outcomes included mean HbA1c at baseline versus 12 months post-insulin program enrollment, patient satisfaction evaluated with a survey and adherence to routine labs, specifically HbA1c and urine albumin-creatinine ratio (UACR) pre- and post-enrollment. Results A total of 21 patients met inclusion criteria. The mean HbA1c before program enrollment was 9.4%, compared to a mean HbA1c of 8.6% six months after enrollment (p= 0.058) and 8.4% twelve months after enrollment when available (p= 0.097). Of the twelve patients that completed the patient satisfaction survey, eleven (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 T2DM enrolled in a low cost, in-office insulin program, change in mean HbA1c after six and twelve months was not statistically significant.