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Trends in Insulin Prescribing for Patients With Diabetes During the COVID-19 Pandemic in the US

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

For the approximately 7 million US individuals with diabetes who rely on insulin,1 the number of insulin prescriptions rose steadily in the decade before the COVID-19 pandemic.2 Reduced access to medical care and disruptions in supply related to the pandemic may have decreased access to insulin,3 with possible adverse consequences for diabetes control.4 Conversely, emergency Medicaid expansions that increased capacity for telemedicine services during the pandemic may have been associated with improved access to treatment.5 Therefore, this study aimed to assess whether changes to insulin prescription claims occurred during the COVID-19 pandemic.

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Accepted for Publication: September 1, 2021.

Published: November 3, 2021. doi:10.1001/jamanetworkopen.2021.32607

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Yunusa I et al. JAMA Network Open.

Corresponding Author: Ismaeel Yunusa, PharmD, PhD, Department of Clinical Pharmacy and Outcomes Sciences, University of South Carolina College of Pharmacy, 715 Sumter St, Columbia, SC 29208 (iyunusa@mailbox.sc.edu).

Author Contributions: Drs Love and Yunusa had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Yunusa, Love, Cai, Hastings, Reeder, Phillips.

Acquisition, analysis, or interpretation of data: Yunusa, Love, Cai, Blake, Phillips.

Drafting of the manuscript: Yunusa, Phillips.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Yunusa, Love, Reeder.

Administrative, technical, or material support: Yunusa, Cai, Hastings, Reeder, Blake, Phillips.

Supervision: Love.

Conflict of Interest Disclosures: Drs Love, Blake, and Phillips reported receiving nonfinancial support from IQVIA during the conduct of the study. Dr Phillips reported receiving salary reimbursement and grants through the University of South Carolina from Prisma Health (where she practices and consults) and serving as a volunteer cochair for the Endocrine and Metabolism Practice Research Network of the American College of Clinical Pharmacy. No other disclosures were reported.

Disclaimer: The statements, findings, conclusions, views, and opinions contained and expressed in this article are based in part on data obtained under license from the IQVIA Institute, Source: US Prescription Claims, January 2018–October 2020, IQVIA Inc. All Rights Reserved. The statements, findings, conclusions, views, and opinions contained and expressed herein are not necessarily those of IQVIA Inc or any of its affiliated or subsidiary entities.

Additional Contributions: We thank Allen Campbell, BS, from IQVIA customer support for facilitating access to these data. Mr Campbell did not receive any payment from the authors for his contribution.

Additional Information: Data were provided by IQVIA Inc as part of an IQVIA Human Data Science Research Collaborative agreement.

References
1.
Cefalu  WT , Dawes  DE , Gavlak  G ,  et al.  Insulin access and affordability working group: conclusions and recommendations.   Diabetes Care. 2018;41(6):1299-1311. doi:10.2337/dci18-0019PubMedGoogle ScholarCrossref
2.
Montvida  O , Shaw  J , Atherton  JJ , Stringer  F , Paul  SK .  Long-term trends in antidiabetes drug usage in the U.S.: real-world evidence in patients newly diagnosed with type 2 diabetes.   Diabetes Care. 2018;41(1):69-78. doi:10.2337/dc17-1414PubMedGoogle ScholarCrossref
3.
Bornstein  SR , Rubino  F , Ludwig  B ,  et al.  Consequences of the COVID-19 pandemic for patients with metabolic diseases.   Nat Metab. 2021;3(3):289-292. doi:10.1038/s42255-021-00358-yPubMedGoogle ScholarCrossref
4.
Apicella  M , Campopiano  MC , Mantuano  M , Mazoni  L , Coppelli  A , Del Prato  S .  COVID-19 in people with diabetes: understanding the reasons for worse outcomes.   Lancet Diabetes Endocrinol. 2020;8(9):782-792. doi:10.1016/S2213-8587(20)30238-2PubMedGoogle ScholarCrossref
5.
Patel  SY , Mehrotra  A , Huskamp  HA , Uscher-Pines  L , Ganguli  I , Barnett  ML .  Trends in outpatient care delivery and telemedicine during the COVID-19 pandemic in the US.   JAMA Intern Med. 2021;181(3):388-391. doi:10.1001/jamainternmed.2020.5928PubMedGoogle ScholarCrossref
6.
Vaduganathan  M , van Meijgaard  J , Mehra  MR , Joseph  J , O’Donnell  CJ , Warraich  HJ .  Prescription fill patterns for commonly used drugs during the COVID-19 pandemic in the United States.   JAMA. 2020;323(24):2524-2526. doi:10.1001/jama.2020.9184PubMedGoogle ScholarCrossref
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