The influence of the insulin volume-based project on the medication structure of patients with type 2 diabetes in the special outpatient service, and its popularization and application

doi:10.5246/jcps.2026.04.027

Abstract

Abstract:

To investigate the association between the insulin volume-based procurement program and changes in medication patterns as well as clinical outcomes among outpatients with type 2 diabetes mellitus (T2DM) in specialized clinics, a retrospective cohort study was conducted. A total of 280 T2DM patients who met rigorous inclusion and exclusion criteria and attended the endocrinology specialty clinic between January 2023 and March 2024 were included. Participants were assigned to either the control group (n = 140) or the observation group (n = 140) according to the implementation period of the insulin volume-based procurement program. Propensity score matching was applied to balance baseline characteristics between the two groups. Comparisons were made regarding medication patterns, economic burden, glycemic control, medication adherence, and adverse events. Multivariate analyses were further performed to adjust for potential confounders. Results showed that the proportion of long-acting insulin use in the observation group (58.57%) was significantly higher than that in the control group (45.71%, P = 0.022). The mean monthly insulin expenditure was markedly lower in the observation group (228.73 ± 52.16 CNY) than in the control group (432.65 ± 85.42 CNY), representing a 47.13% reduction (P < 0.001). After adjusting for age, sex, disease duration, and other covariates, the mean HbA1c level in the observation group (7.32% ± 1.15%) remained significantly lower than that in the control group (7.85% ± 1.24%, P = 0.001). The MMAS-8 adherence score was also higher in the observation group (6.85 ± 0.92) than in the control group (6.23 ± 1.15, P < 0.001). No significant difference was observed in the incidence of adverse events between groups (P = 0.706). In summary, the insulin volume-based procurement program was associated with a substantial reduction in patients’ economic burden, optimization of insulin utilization patterns, and enhanced medication adherence, ultimately contributing to improved glycemic control among T2DM outpatients in specialized clinics.

Key words: Insulin, Volume-based procurement, Type 2 diabetes mellitus, Medication patterns, Medication adherence, Glycemic control

Supporting:

Yudan Lu, Lingyuan Xu, Haisheng Zeng, Lu Gan, Jing Huang, Qiji Zhou. The influence of the insulin volume-based project on the medication structure of patients with type 2 diabetes in the special outpatient service, and its popularization and application[J]. Journal of Chinese Pharmaceutical Sciences, 2026, 35(4): 381-390.

Figures/Tables 4

Table 1. Comparison of general data between the two groups (n (%), x ± s).

Table 2. Comparison of insulin medication structures between the two groups (n (%)).

Table 3. Comparison of blood glucose control indicators between the two groups (x ± s).

Table 4. Comparison of medication adherence scores and classification between the two groups (scores: x ± s; classification: n (%)).

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