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A real‐world study of treatment patterns and outcomes in US managed‐care patients with type 2 Diabetes initiating injectable therapies

AIMS: Examine real‐world outcomes in patients with type 2 diabetes mellitus (T2DM) initiating injectable therapy as part of the Initiation of New Injectable Treatment Introduced after Antidiabetic Therapy with Oral‐only Regimens (INITIATOR) study. MATERIALS AND METHODS: Linked insurance claims and m...

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Autores principales: Wei, Wenhui, Buysman, Erin, Grabner, Michael, Xie, Lin, Brekke, Lee, Ke, Xuehua, Chu, James W., Levin, Philip A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Blackwell Publishing Ltd 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5347924/
https://www.ncbi.nlm.nih.gov/pubmed/27860158
http://dx.doi.org/10.1111/dom.12828
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author Wei, Wenhui
Buysman, Erin
Grabner, Michael
Xie, Lin
Brekke, Lee
Ke, Xuehua
Chu, James W.
Levin, Philip A.
author_facet Wei, Wenhui
Buysman, Erin
Grabner, Michael
Xie, Lin
Brekke, Lee
Ke, Xuehua
Chu, James W.
Levin, Philip A.
author_sort Wei, Wenhui
collection PubMed
description AIMS: Examine real‐world outcomes in patients with type 2 diabetes mellitus (T2DM) initiating injectable therapy as part of the Initiation of New Injectable Treatment Introduced after Antidiabetic Therapy with Oral‐only Regimens (INITIATOR) study. MATERIALS AND METHODS: Linked insurance claims and medical record data were collected from 2 large US health insurers (April 1, 2010 to March 31, 2012) of T2DM adults initiating treatment with glargine (GLA) or liraglutide (LIRA). Baseline characteristics were examined and changes in 12‐month follow‐up outcomes were described for both treatment groups: HbA1c, weight change, hypoglycaemia, persistence, healthcare utilisation and costs. RESULTS: A total of 4490 patients were included (GLA, 2116; LIRA, 2374). At baseline, GLA patients had significantly higher HbA1c vs LIRA patients (9.72% vs 8.19%; P < .001), lower likelihood of having HbA1c < 7% (7.1% vs 23.8%; P < .001), lower bodyweight (100.9 kg vs 110.9 kg, P < .001), higher Charlson Comorbidity Index score (0.88 vs 0.63; P < .001), and higher diabetes‐related costs ($3492 vs $2089; P < .001), respectively. During 12‐months of follow‐up, treatment persistence was 64%, mean HbA1c reduction was −1.24% and weight change was + 1.17 among GLA patients, and was 49%, −0.51% and −2.74 kg, respectively, among LIRA patients. Diabetes‐related costs increased significantly from baseline to follow‐up for LIRA patients ($2089 vs $3258, P < .001) but not for GLA patients ($3492 vs $3550, P = .890). CONCLUSIONS: There were clinically relevant baseline differences in both groups, suggesting that GLA and LIRA are prescribed for different patient groups, and highlighting that efficacy results from clinical trials do not always translate into real‐world practice. Significant increases in healthcare costs were observed in the LIRA group, warranting further cost‐effectiveness analysis.
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spelling pubmed-53479242017-03-23 A real‐world study of treatment patterns and outcomes in US managed‐care patients with type 2 Diabetes initiating injectable therapies Wei, Wenhui Buysman, Erin Grabner, Michael Xie, Lin Brekke, Lee Ke, Xuehua Chu, James W. Levin, Philip A. Diabetes Obes Metab Original Articles AIMS: Examine real‐world outcomes in patients with type 2 diabetes mellitus (T2DM) initiating injectable therapy as part of the Initiation of New Injectable Treatment Introduced after Antidiabetic Therapy with Oral‐only Regimens (INITIATOR) study. MATERIALS AND METHODS: Linked insurance claims and medical record data were collected from 2 large US health insurers (April 1, 2010 to March 31, 2012) of T2DM adults initiating treatment with glargine (GLA) or liraglutide (LIRA). Baseline characteristics were examined and changes in 12‐month follow‐up outcomes were described for both treatment groups: HbA1c, weight change, hypoglycaemia, persistence, healthcare utilisation and costs. RESULTS: A total of 4490 patients were included (GLA, 2116; LIRA, 2374). At baseline, GLA patients had significantly higher HbA1c vs LIRA patients (9.72% vs 8.19%; P < .001), lower likelihood of having HbA1c < 7% (7.1% vs 23.8%; P < .001), lower bodyweight (100.9 kg vs 110.9 kg, P < .001), higher Charlson Comorbidity Index score (0.88 vs 0.63; P < .001), and higher diabetes‐related costs ($3492 vs $2089; P < .001), respectively. During 12‐months of follow‐up, treatment persistence was 64%, mean HbA1c reduction was −1.24% and weight change was + 1.17 among GLA patients, and was 49%, −0.51% and −2.74 kg, respectively, among LIRA patients. Diabetes‐related costs increased significantly from baseline to follow‐up for LIRA patients ($2089 vs $3258, P < .001) but not for GLA patients ($3492 vs $3550, P = .890). CONCLUSIONS: There were clinically relevant baseline differences in both groups, suggesting that GLA and LIRA are prescribed for different patient groups, and highlighting that efficacy results from clinical trials do not always translate into real‐world practice. Significant increases in healthcare costs were observed in the LIRA group, warranting further cost‐effectiveness analysis. Blackwell Publishing Ltd 2017-01-20 2017-03 /pmc/articles/PMC5347924/ /pubmed/27860158 http://dx.doi.org/10.1111/dom.12828 Text en © 2016 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Wei, Wenhui
Buysman, Erin
Grabner, Michael
Xie, Lin
Brekke, Lee
Ke, Xuehua
Chu, James W.
Levin, Philip A.
A real‐world study of treatment patterns and outcomes in US managed‐care patients with type 2 Diabetes initiating injectable therapies
title A real‐world study of treatment patterns and outcomes in US managed‐care patients with type 2 Diabetes initiating injectable therapies
title_full A real‐world study of treatment patterns and outcomes in US managed‐care patients with type 2 Diabetes initiating injectable therapies
title_fullStr A real‐world study of treatment patterns and outcomes in US managed‐care patients with type 2 Diabetes initiating injectable therapies
title_full_unstemmed A real‐world study of treatment patterns and outcomes in US managed‐care patients with type 2 Diabetes initiating injectable therapies
title_short A real‐world study of treatment patterns and outcomes in US managed‐care patients with type 2 Diabetes initiating injectable therapies
title_sort real‐world study of treatment patterns and outcomes in us managed‐care patients with type 2 diabetes initiating injectable therapies
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5347924/
https://www.ncbi.nlm.nih.gov/pubmed/27860158
http://dx.doi.org/10.1111/dom.12828
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