Glucagon fill rates and cost among children and adolescents with type 1 diabetes in the United States, 2011–2021
Authors' conclusion
Roughly 30% of commercially-insured youth with T1DM may lack access to unexpired glucagon, with significant disparities among Black and low-income patients. Health systems, clinicians, schools, and caregivers should work together to ensure children have reliable access to this critical medication.
Study context
- Population
- Commercially-insured youth with T1D in OptumLabs Data Warehouse, 2011–2021; 76.4% non-Hispanic White
- Participants
- 13,267 participants
- Outcome
- Glucagon fill rates and costs, overall and by formulation
Methodological detailsclaims-based analysis, Cox regression
- Claims-based analysis
- Cox regression
Main finding
As reported in the abstract
Glucagon filled · mean follow-up 2.81 years (SD 2.62)
Filled glucagon
70.0%
Intranasal glucagon share of all fills by 2021, after rapid uptake following approval
46.6%
Annual mean out-of-pocket costs
$21-$68
IQR $29-$44
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Factors associated with glucagon fills (Cox regression)Annual household income ≥$200,000vs <$40,000 | 1.39 (1.27–1.52) | |
| Factors associated with glucagon fills (Cox regression)Black racevs White race | 0.83 (0.76–0.91) | |
| 0.512Hazard ratio (log scale) |
- Factors associated with glucagon fills (Cox regression): income positively associated with fills in a stepwise fashion
Original publication
Glucagon fill rates and cost among children and adolescents with type 1 diabetes in the United States, 2011–2021. Diabetes Res Clin Pract. Published 23 November 2023. doi:10.
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