MEDICATION CONSUMPTION IN DIABETES-MELLIT US .5. PHARMACOECONOMICS AND ACCEPTATION OF HOSPITAL CONVERSION TO U100 INSULIN

BACKGROUND: The U100 insulin (100 units [U]/ml) in only used in a mino rity of Spanish hospitals and is not ordinarilly evaluated. To study t he convenience of converting from U40 (40 U/ml) to U100 insulin in a f irst level hospital, the procedure, costs and professional acceptation were analyzed after one year of experience. SUBJECTS AND METHODS: The chronology and the transfer method are described making an interannua l pharmacoeconomical comparison of costs U40/U100 based on insulin int ake and injection material. The primary source of information was the computerized base of admission, pharmacy and supply. The secondary sou rce included the obligatory registries of daily medicine sheets. Nursi ng staff acceptance of the new system (preloaded U100 syringes) was an alyzed with a predesigned quantitative scale questionnaire. RESULTS: I n the U40 phase, 69,600 U and 8,260 syringes were used to satisfy 136 diabetics at a mean prescription of 21 U/day for 10.9 days. In the U10 0 phase, 92,100 U and 1,682 syringes were used for 132 admissions with a mean dosis of 20 U during 8.6 days. The insulin prescribed and inje cted was 45.5% and 24.7%, respectively with the consumption of non inj ected insulin in the center being 20.8%. On taking only the fraction i njected into consideration, the mean daily cost per complete treatment was lower in U100 (116/84 and 1,368/809 pesetas; p < 0.0001) represen ting 0.53% (U40) and 0.36% (U100) of hospital stay costs. The total co st increased by 44 ptas./patient/day during the first year of conversi on. Each section of the 67 questionnaires evaluated scored from 4 (gre atest acceptation) to 20 (lowest acceptation). The general mean was 6. 8 +/- 1.6 with no significant differences between the section of manag ement/manipulation of U100 devices (6.7 +/- 2.1), learning and protoco l (7.3 +/- 2.6) and patient education (6.5 +/- 1.8; p = 0.07, NS). CON CLUSIONS: Current hospital conversion to U100 insulin requires the use of mechanized injection systems which represent a slight extra cost o f scarce social relevance and are greatly accepted by users if adequat e transfer procedures are applied.