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Project Baiterek: A Patient Access Program to Improve Clinical Outcomes and Quality of Life in Children with Type 1
Aigul Muratalina1, Jayne Smith-Palmer2, Akmaral Nurbekova3
1Medtronic Plc, Almaty, Kazakhstan.
Insights
Project Baiterek improved type 1 diabetes management in Kazakhstan children using continuous subcutaneous insulin infusion (CSII) therapy. This initiative enhanced clinical outcomes, quality of life, and proved cost-effective, offering a model for global noncommunicable disease care.
Area of Science:
- Endocrinology
- Public Health
- Health Economics
Background:
- Type 1 diabetes is a growing global health concern, leading to significant complications and healthcare burdens.
- Suboptimal diabetes management and access to care in many regions exacerbate the risk of complications.
- Project Baiterek aimed to address these challenges by improving access to advanced diabetes technology.
Purpose of the Study:
- To evaluate the clinical, quality-of-life, and economic outcomes of continuous subcutaneous insulin infusion (CSII) therapy for children with type 1 diabetes in Kazakhstan.
- To assess the impact of a nationwide project on insulin pump accessibility and utilization.
- To determine the cost-effectiveness of CSII compared to traditional multiple daily injection therapy.
Main Methods:
- Implementation of a collaborative, countrywide initiative (Project Baiterek) involving government, industry, and healthcare providers.
- Introduction of continuous subcutaneous insulin infusion (CSII) therapy for pediatric patients with type 1 diabetes.
- Longitudinal data collection on clinical outcomes, quality of life, and economic impact.
Main Results:
- CSII therapy significantly improved clinical outcomes and patient quality of life in the studied pediatric population.
- Insulin pump utilization increased from 0% to two-thirds among children with type 1 diabetes within three years.
- CSII therapy demonstrated cost-effectiveness when compared to multiple daily injection therapy.
Conclusions:
- Project Baiterek successfully expanded access to CSII therapy, improving health outcomes for children with type 1 diabetes in Kazakhstan.
- The project's framework offers a scalable model for enhancing care and access to technology for noncommunicable diseases globally.
- Improved access to advanced therapies like CSII can mitigate the economic and social burdens associated with diabetes complications.
Abstract:
Diabetes is a key driver in the rise of noncommunicable diseases globally. It causes expensive and burdensome short- and long-term complications, with both an economic and social impact. In many countries, however, access to care and disease management in type 1 diabetes is suboptimal, increasing the risk for complications. In 2011, Project Baiterek was initiated as a collaborative effort between the Kazakhstan Ministry of Health, industry (Medtronic Plc), local physicians, and the Diabetes Association of the Republic of Kazakhstan to enhance patient access to continuous subcutaneous insulin infusion (CSII) therapy. It was the first countrywide project to provide equity and universal access to insulin pump therapy among children with type 1 diabetes, increasing pump use from zero to two-thirds of this population in less than 3 years. The project also involved instigating longitudinal data collection, and long-term clinical outcomes continue to be monitored. Here, we provide an overview of the clinical, quality-of-life, and economic outcomes to date associated with providing CSII therapy to children with type 1 diabetes in Kazakhstan. Initial clinical data show that CSII therapy improved clinical outcomes and quality of life for patients entered into the program and that CSII therapy was cost-effective relative to multiple daily injection therapy. The positive outcomes of Project Baiterek provide a template for similar patient access programs in other settings, and its framework could be adapted to initiatives to change health care infrastructures and standards of care for other noncommunicable diseases.
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