Appropriate Access: Payer Perspective on Newer Insulins
Louis S. Christos, RPh: From the payer perspective, appropriate access for the ultra–long acting products, again, is, from our perspective, driven by the provider. They will be the ones who actually determine who the appropriate patients are. We can make assumptions of who we think the right patients are. For patients who are on basal insulin, currently, and they have tolerability issues (they have hypoglycemia events), switching them to an ultra–long acting drug that has a lower rate of hypoglycemic events would make logical sense. In patients who are new to insulin therapy (type 2 patients who are on multiple orals who are going to switch to an insulin), it would make logical sense to switch them over to an ultra–long acting therapy that, again, has a lower rate of hypoglycemic events. But at the end of the day, it is the provider making that determination, and, as a payer, we allow access based on individualization of treatment.
Because of the difficulties in patients’ scheduling, whether they have work or any other activities, the flexibility in dosing does allow them to dose at a later time, to dose around their schedule. That way, they don’t have to be too concerned about scheduling that dose at the same time, every day.
The flexibility in dosing is a benefit for the patient. If they do tend to forget to administer a dose when they’re told that they have to take the dose (at the same time, every day), this flexibility allows them hours, although I’m not sure exactly what the range was. It does allow them the flexibility to dose it later than usual, given the flexibility and the convenience of that dosing.