Health economics and compliance of vials/syringes versus pen devices: a review of the evidence

The goal of this review was to assess the state of the published literature on health economics and compliance of vials/syringes versus pen devices. A literature search was performed using the Embase search engine for publications that linked drug terms (insulin and insulin lispro) to disease terms (insulin-dependent diabetes mellitus, non-insulin-dependent diabetes mellitus) and other terms (accuracy, article, clinical trial, controlled clinical trial, controlled study, cost benefit analysis, drug delivery system, drug dosage form, drug dosage form comparison, drug dose comparison, drug preference, equipment design, force, glycemic control, healthcare cost, human, insulin treatment, needle, patient attitude, patient compliance, patient safety, torque) along with author keywords (Diabetes, Dose accuracy, FlexPen [Novo Nordisk, Bagsvaerd, Denmark], Insulin, Next Generation FlexPen). The search yielded 39 articles, of which five articles met our study criteria. The focus of the critical outcomes was patient adherence to insulin pen devices versus insulin vials (syringes), hypoglycemic events, emergency department visits due to hypoglycemic events, and costs associated with diabetes and health care. The observation period, mean age of patients, and data sources differed across the studies. The studies indicated that there was an improved adherence with insulin pen devices as opposed to insulin vials (syringes) and that the associated healthcare resource utilization and costs associated with them were found to decrease with the use of pen devices, compared to vials. The use of pen devices improves the health economics benefits and adherence to insulin therapy.