OBJECTIVES : Healthcare workers often administer subcutaneous insulin injections and face a risk of needlestick injuries (NSIs). Almost 20% of all syringe NSIs are related to insulin injections. Pen needles with safety engineered features on both front (patient) and back (device) ends are recommended. In addition, patient safety benefits exist with shorter needles which may reduce the risk of insulin intramuscular (IM) injections and hypoglycemia. A model was developed to estimate the budget impact of using shorter dual-ended safety pen needles relative to longer single-ended safety pen needles for insulin injections by reducing the risk of NSIs and hypoglycemia.

METHODS : A 1-year budget impact model was developed from the perspective of a US hospital taking into account device acquisition costs, direct costs of NSIs, and direct costs associated with an extended length of stay due to hypoglycemia caused by IM insulin injections. Model inputs were derived from the CDC, published literature, and market research. Costs were adjusted to 2017 dollars.

RESULTS : For a 500 bed hospital, an estimated 74,141 insulin injections occurred annually (base case). The total annual cost of insulin injections taking into account device acquisition ($22,242), NSIs ($5,165), and hypoglycemia ($30,659) is estimated to be $58,066 with longer single-ended safety pen needles. If all injections were conducted with 5mm dual-ended safety pen needles, the model estimates costs of $36,970, which represents a cost savings of $21,096. Greater acquisition costs for 5mm dual-ended safety needles are offset by a reduction in NSIs as well as reduced risks of hypoglycemia.

CONCLUSIONS : The budget impact model suggests that utilizing 5mm dual-ended safety pen needles for insulin injections in acute care improves clinical outcomes and reduces economic burden associated with NSIs compared to longer single-ended safety pen needles. Similar costs savings could be realized across other healthcare settings where insulin is administered (e.g., long term care).