Background: to assess costs and safety of insulin pen devices and safety needles as compared
to vial/syringes in hospitalized patients requiring insulin therapy in a General Hospital in
Materials and Methods: in a prospective 9-month study, consecutive patients admitted to three Hospital
Units received insulin therapy through either a traditional disposable syringe method, or
pen/safety needles with dual-ended protection, or disposable safety syringes. We compared the median
direct (insulin and devices) and indirect (insulin supply at discharge, insulin wastage) costs of a
10-day in-hospital insulin treatment in the 3 study groups, additionally accounting for the costs related
to the observed needlestick injury rate. Patients’ safety during in-hospital stay (hypo- and hyperglycemia
episodes) and satisfaction were also assessed.
Results: N=360 patients (55% men, mean age 75.6 years, 57% with DM since ≥10 years) were recruited
in the study. Insulin pens had higher median direct cost than both traditional syringes (43 vs.
18 ε/patient, p<.0001) and safety syringes (21.5 ε/patient, p<.0001). However, when also indirect
and injuries costs were taken into account, the estimated savings for using pens over traditional syringes
were as high as 32 ε/patient (45.8 vs. 77.6 ε/patient, p-value <.0001). No differences in patients’
safety were observed. 74% and 12% of patients using pens and syringes would like to continue
the method at home, respectively (p<0.0001).
Discussion: A selective use of individual pre-filled pens/safety needles for patients who are likely to
continue insulin therapy at home may strongly reduce hospital diabetes treatment related costs.