Up to 80% of Medicaid patients may be using insulin glargine past recommended discard date

JAPhA study: Pharmacists may help improve appropriate use and disposal

Many Medicaid patients who use insulin glargine multiple-dose vials may be using it beyond the 28-day limit on punctured bottles, possibly leading to questionable product stability and sterility, according to research published online in the Journal of the American Pharmacists Association.

In the study, researchers at Molina Healthcare identified Medicaid patients with diabetes in Utah, Ohio, Michigan, and California who took insulin glargine from January 1 through December 31, 2015, and interviewed 12 of them. They included Medicaid patients to help ensure that cost was not a factor in how long the patients used the product.

Of the 12 patients who were interviewed, 8 said they did not dispose of their insulin after 28 days of use because they were unaware of the 28-day limit. The remaining four disposed of the insulin after 28 says as recommended, two because a pharmacist had instructed them in what to do and two because they learned about the limit through diabetes education.

According to the researchers, the study suggests that education by pharmacists and other health providers may improve appropriate use of insulin glargine. In their conclusion they write, “Pharmacists often have the most contact opportunities with patients and are thus ideally placed to provide education and reinforce appropriate medication use.”