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Adherence to Basal Insulin Therapy Among People with Type 2 Diabetes: A Retrospective Cohort Study of Costs and Patient Outcomes

INTRODUCTION: This research compares costs, resource utilization, and complications between adherent and nonadherent patients over the 3-year period post initiation on basal insulin therapy. METHODS: The study utilized the US-based Truven Health MarketScan(®) Research Databases from 2011 through 201...

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Autores principales: Perez-Nieves, Magaly, Boye, Kristina S., Kiljanski, Jacek, Cao, Dachung, Lage, Maureen J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Healthcare 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5984924/
https://www.ncbi.nlm.nih.gov/pubmed/29644618
http://dx.doi.org/10.1007/s13300-018-0421-5
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author Perez-Nieves, Magaly
Boye, Kristina S.
Kiljanski, Jacek
Cao, Dachung
Lage, Maureen J.
author_facet Perez-Nieves, Magaly
Boye, Kristina S.
Kiljanski, Jacek
Cao, Dachung
Lage, Maureen J.
author_sort Perez-Nieves, Magaly
collection PubMed
description INTRODUCTION: This research compares costs, resource utilization, and complications between adherent and nonadherent patients over the 3-year period post initiation on basal insulin therapy. METHODS: The study utilized the US-based Truven Health MarketScan(®) Research Databases from 2011 through 2015. Adults aged 18 years or older and identified with type 2 diabetes (T2D) who initiated therapy on basal insulin in 2012 were included. Patients were excluded if they were pregnant, filled their index basal insulin prescription via mail order, or were not continuously insured from 1 year before through 3 years following initiation of treatment with basal insulin. Instrumental variables were used to control for selection bias, and multivariable analyses were used to examine the associations between adherence to basal insulin therapy and costs, resource utilization, and acute complications. RESULTS: A total of 21,363 individuals were included in the study. Three years after initiating therapy on basal insulin, patients who were adherent over time to basal insulin treatment therapy (33.8% of patients) had significantly higher diabetes-related drug costs. However, patients’ adherence was associated with significantly lower diabetes-related outpatient, acute care, and total costs. Results for all-cause costs were similar. Adherent patients also had significantly fewer all-cause and diabetes-related hospitalizations and emergency room visits and were significantly less likely to be diagnosed with an acute complication. CONCLUSIONS: Results of this study illustrate that despite higher drug costs, there are disease-specific and all-cause cost offsets and improved patient outcomes associated with adherence to basal insulin therapy for people with T2D. FUNDING: Eli Lilly and Company. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s13300-018-0421-5) contains supplementary material, which is available to authorized users.
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spelling pubmed-59849242018-06-13 Adherence to Basal Insulin Therapy Among People with Type 2 Diabetes: A Retrospective Cohort Study of Costs and Patient Outcomes Perez-Nieves, Magaly Boye, Kristina S. Kiljanski, Jacek Cao, Dachung Lage, Maureen J. Diabetes Ther Original Research INTRODUCTION: This research compares costs, resource utilization, and complications between adherent and nonadherent patients over the 3-year period post initiation on basal insulin therapy. METHODS: The study utilized the US-based Truven Health MarketScan(®) Research Databases from 2011 through 2015. Adults aged 18 years or older and identified with type 2 diabetes (T2D) who initiated therapy on basal insulin in 2012 were included. Patients were excluded if they were pregnant, filled their index basal insulin prescription via mail order, or were not continuously insured from 1 year before through 3 years following initiation of treatment with basal insulin. Instrumental variables were used to control for selection bias, and multivariable analyses were used to examine the associations between adherence to basal insulin therapy and costs, resource utilization, and acute complications. RESULTS: A total of 21,363 individuals were included in the study. Three years after initiating therapy on basal insulin, patients who were adherent over time to basal insulin treatment therapy (33.8% of patients) had significantly higher diabetes-related drug costs. However, patients’ adherence was associated with significantly lower diabetes-related outpatient, acute care, and total costs. Results for all-cause costs were similar. Adherent patients also had significantly fewer all-cause and diabetes-related hospitalizations and emergency room visits and were significantly less likely to be diagnosed with an acute complication. CONCLUSIONS: Results of this study illustrate that despite higher drug costs, there are disease-specific and all-cause cost offsets and improved patient outcomes associated with adherence to basal insulin therapy for people with T2D. FUNDING: Eli Lilly and Company. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s13300-018-0421-5) contains supplementary material, which is available to authorized users. Springer Healthcare 2018-04-11 2018-06 /pmc/articles/PMC5984924/ /pubmed/29644618 http://dx.doi.org/10.1007/s13300-018-0421-5 Text en © The Author(s) 2018 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Research
Perez-Nieves, Magaly
Boye, Kristina S.
Kiljanski, Jacek
Cao, Dachung
Lage, Maureen J.
Adherence to Basal Insulin Therapy Among People with Type 2 Diabetes: A Retrospective Cohort Study of Costs and Patient Outcomes
title Adherence to Basal Insulin Therapy Among People with Type 2 Diabetes: A Retrospective Cohort Study of Costs and Patient Outcomes
title_full Adherence to Basal Insulin Therapy Among People with Type 2 Diabetes: A Retrospective Cohort Study of Costs and Patient Outcomes
title_fullStr Adherence to Basal Insulin Therapy Among People with Type 2 Diabetes: A Retrospective Cohort Study of Costs and Patient Outcomes
title_full_unstemmed Adherence to Basal Insulin Therapy Among People with Type 2 Diabetes: A Retrospective Cohort Study of Costs and Patient Outcomes
title_short Adherence to Basal Insulin Therapy Among People with Type 2 Diabetes: A Retrospective Cohort Study of Costs and Patient Outcomes
title_sort adherence to basal insulin therapy among people with type 2 diabetes: a retrospective cohort study of costs and patient outcomes
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5984924/
https://www.ncbi.nlm.nih.gov/pubmed/29644618
http://dx.doi.org/10.1007/s13300-018-0421-5
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