Markets Self Administration

Self Administration

Millions of patients around the world each year self-administer prescription medication with a syringe outside of a healthcare facility. The most common market for the self-administration of prescribed drugs is the treatment of diabetes with insulin. Patients also increasingly self-administer prescription medication outside of the healthcare setting for a range of other conditions. This trend towards self-care in the home is being driven by patient convenience, the development of simple-to-administer injectable drugs and the reduction of costs associated with treatment within healthcare facilities.

Risk Factors and Related Increases in the Incidence of Lipohypertrophy*
Needle Change Frequency Incidence of Lipohypertrophy (%)
Every injection 20.30%
Every 2–3 injections 51.20%
Every 4–5 injections 75%

* Polonsky WH, Jackson RA, Clinical Diabetes, 2004;22(3):147–50

Whilst most insurance plans in the U.S. provide sufficient coverage for the single use of syringes secured with a prescription, many people with diabetes continue to reuse non-sterile products. The needles of reused syringes can become damaged and bent, with the silicone lubricant used to coat the needle being reduced. This could result in a more painful injection, with possible bleeding, bruising or the breaking off and embedding of a needle tip under the skin. The risk of lipohypertrophy, grape-like lumps of excessive fat on the skin, also increases significantly with syringe reuse.

Over three billion needles, syringes, and lancets are used in the US alone each year by more than eight million patients who have diabetes. After being used and discarded, a significant proportion of these syringes end up in the public solid waste system. This presents a risk of needlestick injury and infection, mostly to waste disposal workers. Some are also discarded in public areas, such as parks, presenting a risk to the public. Loved ones around the home, particularly children, may also be at risk from syringes which are not immediately disposed of after use in approved sharps disposal containers.

The mandatory use of safety syringes within healthcare facilities in most cases does not extend to the self-administration of prescribed medication by patients. However, U.S. government agencies and insurance providers are increasingly seeking to provide patients with access to single-use syringes with needlestick prevention features. Many U.S healthcare insurers in the U.S. now subsidize the cost of insulin safety syringes under the same tier structure as standard products. Moreover, the Centers for Medicare & Medicaid Services (CMS) have introduced a requirement that all long-term care pharmacies and Medicare Part D sponsors (healthcare suppliers) provide insulin safety syringes.