Introduction: Continuous Subcutaneous Insulin Infusion (CSII) treatment for people with type 1 diabetes (T1D) is fully funded in Ireland via the Long-Term Illness scheme (LTI) and, similarly as in some other developed countries such as Germany, Sweden or the UK, does not involve any out-of-pocket expenses for the person with T1D. Uptake of CSII in adults has been reported to vary from 6.7% (Wales, 2018), through 15.6% (England, 2018) up to >50% in the United States (in 2012). However, available evidence on the uptake of CSII, particularly in adults, is scarce.
The aim of this study was to estimate the uptake of CSII in Ireland.
Methods: A retrospective cross-sectional study was conducted utilizing the Irish Health Service Executive Primary Care Reimbursement Service (HSE-PCRS) national pharmacy claims database data from the years 2011-2016. Individuals with T1D were identified by co-prescription of insulin and glucometer test strips without any prolonged course (>12 months) of oral hypoglycemic agents prior to commencing insulin. Individuals using CSII were identified by a prescription of infusion sets.
Results: Of all adults with T1D (>18 years of age) meeting our criteria (n=19,551), only 5.84% (n=1141) were claiming infusion sets (95% CI 5.51% - 6.16%). The uptake of CSII varied geographically across Ireland from as low as 1.68% to 8.35%.
Conclusions: In comparison to other countries where CSII therapy is fully covered, uptake of CSII was low in Irish adults. The determinants of the uptake (barriers to and facilitators in accessing this diabetes-related technology) are under more in-depth investigation.
K.A. Gajewska: None. S. Sreenan: Advisory Panel; Self; Abbott, AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Novo Nordisk Inc. Other Relationship; Self; Eli Lilly and Company. R. Biesma: None. K. Bennett: None.
Health Research Board (SPHeRE/2013/1)