Study Examines Health Outcomes of Switching Insulin Medications

Rising Costs of Diabetes Medications

A recent study investigated the health outcomes of patients transitioning from newer, more expensive insulin analogues to lower-cost human insulin medications. Over the past 20 years, the costs of diabetes medications have surged, particularly with the introduction of innovative insulin analogues. Although these newer insulin-like medications are faster-acting than human insulin, they come with a higher price tag and may necessitate more daily injections. The study raises questions about whether the reduced time-to-action justifies the additional costs and if they significantly enhance diabetes management.

Research Overview

Researchers at Brigham and Women’s Hospital in Boston have been monitoring the health of diabetic patients who switched from insulin analogues to human insulin. This study commenced in 2015, with its findings recently published in JAMA.

The research encompassed 14,635 adults diagnosed with type 2 diabetes, including 983 participants who switched from insulin analogues to human insulin. The primary focus was on hemoglobin A1c levels, which indicate glycemic control in diabetic patients by binding to glucose. These levels were assessed before the switch, during the transition, and one year post-switch, with comparisons made to the larger group. The study also tracked adverse events related to hypoglycemia and hyperglycemia.

Findings and Implications

The study revealed only minor fluctuations in hemoglobin A1c levels during the transition to human insulin, remaining within normal biological limits. After a one-year follow-up, there were no significant differences in hemoglobin A1c levels between the subgroup of patients who switched and those who did not. Additionally, no notable differences were observed in the rates of serious hyperglycemic or hypoglycemic events among the different medication groups.

Based on these findings, the authors propose that patients can successfully transition from newer, more expensive insulin analogues to lower-cost human insulin without compromising health outcomes. Given the rising out-of-pocket costs for medications, this option may be appealing and practical for many individuals living with type 2 diabetes.

Author and Reference

Written by Agustin Dominguez Iino, BSc
Reference: Luo et al. Implementation of a Health Plan Program for Switching From Analogue to Human Insulin and Glycemic Control Among Medicare Beneficiaries With Type 2 Diabetes. JAMA. 2019 Jan 29;321(4):374-384. doi: 10.1001/jama.2018.21364.