OBJECTIVES: Growing research indicates that structured training in insulin injection techniques - including education on site rotation, lipohypertrophy, needle length, and in some cases transitioning to a shorter needle - reduces insulin consumption and improves glycaemic control, underscoring the importance of proper insulin delivery for optimal diabetes management. This study aims to assess the economic impact of using 4mm Pen Needles (PNs) and providing structured education on insulin administration for patients with diabetes in Spain.

METHODS: A budget impact model was developed to estimate the direct medical costs from the Spanish National Healthcare System (NHS) perspective associated with using 4mm PNs and providing structured education on insulin administration, compared to using longer PNs without any educational support, over a 1-year period. The number of patients eligible to receive 4mm PNs was estimated based on the resident population in Spain, the prevalence of type 1 and type 2 diabetes, and the proportion of patients treated with insulin. Healthcare resource utilization, including insulin usage and management of diabetes-related complications, was derived from literature, and unit costs were obtained from local healthcare databases (€2023). Sensitivity analyses were conducted to test the robustness of the analysis against key variables and assumptions.

RESULTS: A total of 3.5M patients with type 1 or type 2 diabetes were identified in Spain, with 0.7M of them being treated with insulin. Increasing the use of 4mm PNs is projected to generate savings of 30-150€ per-patient per-year. These savings are primarily driven by reduced insulin usage and a decrease in diabetes-related complications, particularly hypoglycaemic events. Total savings depend on current regional consumption patterns and market penetration assumptions.

CONCLUSIONS: Increasing the adoption of 4mm PNs combined with a structured educational program has the potential to optimize diabetes management and could be an effective strategy to reduce healthcare expenditure within the Spanish NHS.