The Danish company developed the device, called Novolin InnoLet, as a direct alternative to conventional vial and syringe dosing. It takes the form of a prefilled container that comprises a large dial to allow patients to select their dose. A fresh needle is inserted into the device for each administration, which is delivered at the touch of a button. Once the Novolin InnoLet is empty, users just throw it away.
In the US study, elderly diabetics with visual or motor disabilities who used the Novolin InnoLet had a reduced need for nursing assistance with their insulin therapy compared to those relying on vial and syringe dosing, reducing the overall cost of care by 42 per cent.
When using Novolin InnoLet, 53 per cent of patients did not require nursing assistance with insulin administration, compared to 20 per cent when using a vial and syringe. The average cost of nursing assistance with Novo's device worked out at $114 per day, compared to $196 for the vial/syringe group (p < 0.001). The study is published in the journal Diabetes Research and Clinical Practice (January 2004).
In addition, 82 per cent of the patients in the study said they preferred to use Novolin InnoLet over a vial and syringe. Ten per cent favoured conventional syringe dosing, and 8 per cent had no preference.
"The complexity of insulin injection procedures, patient dosing errors and patient compliance are among the most important issues in diabetes treatment, especially in elderly patients," said lead study investigator John Shelmet of the Robert Wood Johnson School of Medicine in Piscataway, New Jersey.
The study involved 79 elderly people (average age 68.2 years) who were assigned to self-administer insulin therapy using either a vial and syringe or Novolin InnoLet for six weeks, then switched to the alternate treatment for six additional weeks. At the end of each treatment period, nurses completed questionnaires that assessed the amount of assistance the patients required to administer insulin therapy, and patients completed a questionnaire about their preference and satisfaction with the insulin delivery device.
Importantly, there was no difference between the groups in terms of the control of their blood sugar, or indeed in the incidence of delivery system-related side effects.
On the issue of cost, Novo notes that its new device is available to patients at the same co-payment level as vials and syringes under most US health insurance plans.