Real-world medication persistence and outcomes associated with basal insulin and glucagon-like peptide 1 receptor agonist free-dose combination therapy in patients with type 2 diabetes in the US
Open Access
- 1 December 2016
- journal article
- research article
- Published by Informa UK Limited in ClinicoEconomics and Outcomes Research
- Vol. ume 9, 19-29
- https://doi.org/10.2147/CEOR.S117200
Abstract
Real-world medication persistence and outcomes associated with basal insulin and glucagon-like peptide 1 receptor agonist free-dose combination therapy in patients with type 2 diabetes in the US Jay Lin,1 Melissa Lingohr-Smith,1 Tao Fan2 1Health Economics and Outcomes Research, Novosys Health, Green Brook, NJ, USA; 2North America Medical Affairs, Sanofi US, Inc., Bridgewater, NJ, USA Background: Free-dose combination treatment with basal insulin and short-acting glucagon-like peptide-1 receptor agonists (GLP-1 RAs) reduces hyperglycemia via complementary targeting of fasting and postprandial blood glucose levels, however, in the real world, due to injection burden and clinical inertia, the full efficacy may not be able to translate into clinical and economic benefits. Objective: The aim of the study was to evaluate treatment persistence and associated outcomes in patients with type 2 diabetes (T2D) treated with a GLP-1 RA in free-dose combination with basal insulin. Methods: Claims data were extracted on US adults with T2D with ≥1 prescription claim for both a GLP-1 RA and a basal insulin from July 1, 2008 to June 30, 2013, and continuous health plan coverage for 6 months prior to (baseline) and 12 months after the index date (follow-up period). Outcomes analyzed for patients stratified by treatment persistence included glycemic control, hypoglycemia, and health care costs and resource utilization. Multivariate analyses were used to examine factors associated with persistence or hypoglycemia. Results: The analysis included 7,320 patients, of whom 16.9% were persistent with free-dose combination treatment. The median time to treatment discontinuation was 133 days. Compared with nonpersistent patients, persistent patients had greater glycated hemoglobin A1c (A1C) reductions (–0.80% vs –0.42%; P=0.032), were more likely to achieve A1CKeywords
This publication has 35 references indexed in Scilit:
- Combination therapy with GLP‐1 receptor agonists and basal insulin: a systematic review of the literatureDiabetes, Obesity and Metabolism, 2012
- Basal Insulin and Cardiovascular and Other Outcomes in DysglycemiaNew England Journal of Medicine, 2012
- Uncovering undetected hypoglycemic eventsDiabetes, Metabolic Syndrome and Obesity, 2012
- Combination therapy with insulin glargine and exenatide: real-world outcomes in patients with type 2 diabetesCurrent Medical Research and Opinion, 2012
- Insulin detemir versus insulin glargine for type 2 diabetes mellitusCochrane Database of Systematic Reviews, 2011
- One-year treatment with exenatide vs. Insulin Glargine: Effects on postprandial glycemia, lipid profiles, and oxidative stressAtherosclerosis, 2010
- Further Improvement in Postprandial Glucose Control With Addition of Exenatide or Sitagliptin to Combination Therapy With Insulin Glargine and MetforminDiabetes Care, 2010
- Liraglutide vs insulin glargine and placebo in combination with metformin and sulfonylurea therapy in type 2 diabetes mellitus (LEAD-5 met+SU): a randomised controlled trialDiabetologia, 2009
- One-Year Treatment With Exenatide Improves β-Cell Function, Compared With Insulin Glargine, in Metformin-Treated Type 2 Diabetic PatientsDiabetes Care, 2009
- Tolerability and efficacy of exenatide and titrated insulin glargine in adult patients with type 2 diabetes previously uncontrolled with metformin or a sulfonylurea: A multinational, randomized, open-label, two-period, crossover noninferiority trialClinical Therapeutics, 2007