Helping To Improve Insulin Therapy In China

For most people, healthcare is a personal matter, experienced by a patient and practiced by a professional. But for a select group of individuals specializing in Health Economics and Outcome Research (HEOR), the experience can touch a country. BD employs just such a network of highly trained associates who seek out places where healthcare communities can benefit from adopting proven practices, and presenting evidence supporting such practices to the highest levels of authority.

Diabetes patients practicing injection techniques
Diabetes patients practicing injection techniques.

An example of such activity is unfolding in the People’s Republic of China. More than two years ago, a cross-functional team from BD team—representing medical affairs, marketing, public policy and government relations—was assembled to consider a strategy to accelerate pen needle market access in China. In order to achieve this goal, government reimbursement policy for pen needles needed to be reassessed and adjusted.

To facilitate evidence-based discussions, the group created field communication tools targeted for national, provincial and city-level reimbursement stakeholders. BD in China also invested in a regional HEOR leader to further enhance cross-functional collaboration. The team launched new studies in collaboration with Medical Affairs, including the first Clinical HEOR Study focusing on the clinical and cost burden of lipohypertrophy, a condition that refers to a lump under the skin caused by accumulation of extra fat at the site of many subcutaneous injections of insulin. This condition can change the timing or completeness of insulin action, a problem that can be reduced through educating patients in injection site rotation.

Preparing an insulin pen
Preparing an insulin pen.

Another challenge for the HEOR group has been on discouraging needle reuse for insulin injection. A survey conducted in China in 2013 revealed in a sampling of 3,393 patients, 80% were accustomed to using the same needle three times as a cost-saving measure.1 A re-use study was prepared, providing compelling data on budgetary impact for pen needle reimbursement. Additional communications tools were produced and presented at a meeting for policy makers and national, provincial and community stakeholders.

As a result of this collaboration and its evidence-based advocacy, a new reimbursement policy was approved for diabetes care products in the Jiangsu and Hebei provinces, with potential for improved access and delivery for thousands of diabetes patients, as well as potential economies on the provider side. The work of the HEOR team and its functional collaborators in China continues as the success of policy adoption opens opportunities in additional provinces throughout the country, with 80 million “covered lives” already benefiting from the new policies.

HEOR Team – left to right: Doreen Dong (Medical Affairs); Lichun Jiang (Diabetes Care); Xiaoxiao Ren (Public Affairs and Communications); Anita Wei (Public Affairs and Communications); Shirley Xia (Government Affairs); Danny Chu (Diabetes Care); Julia Liu (Public Affairs and Communications); Steven Wei (Medical Affairs); Benson Hu (Research and Development); Arthi Chandran (HEOR); Fiona Wang (Diabetes Care).

1T Liu, B Cui, J Zhong, Z Zhao, K Yu, L Tao, X Ren. Situation and Impact of Insulin Pen Needle reuse for Patients with Diabetes in China