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Increased Healthcare Resource Use and Costs After Discontinuation of Liraglutide in Patients with Type 2 Diabetes from a Commercial- and Medicaid-Insured Claims Database
INTRODUCTION: Liraglutide, a glucagon-like peptide-1 receptor agonist (GLP-1 RA), is effective in patients with type 2 diabetes (T2D), but treatment discontinuation without new T2D therapy initiation may compromise outcomes. METHODS: This retrospective cohort study (July 1, 2012, to December 31, 201...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Healthcare
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9663787/ https://www.ncbi.nlm.nih.gov/pubmed/36239850 http://dx.doi.org/10.1007/s13300-022-01322-z |
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author | Uzoigwe, Chioma Noone, Josh Liang, Yuanjie Ali, Sarah Naz Gamble, Cory |
author_facet | Uzoigwe, Chioma Noone, Josh Liang, Yuanjie Ali, Sarah Naz Gamble, Cory |
author_sort | Uzoigwe, Chioma |
collection | PubMed |
description | INTRODUCTION: Liraglutide, a glucagon-like peptide-1 receptor agonist (GLP-1 RA), is effective in patients with type 2 diabetes (T2D), but treatment discontinuation without new T2D therapy initiation may compromise outcomes. METHODS: This retrospective cohort study (July 1, 2012, to December 31, 2019) identified patients ≥ 18 years with T2D in the Optum(®) Clinformatics(®) Data Mart who discontinued liraglutide (index date). Patients with continuous enrollment for ≥ 12 months before and after discontinuation (baseline), ≥ 6 months liraglutide coverage pre-index, and no new T2D therapy start during follow-up were included. Changes from baseline in all-cause healthcare resource utilization (HCRU; outpatient visits, emergency room [ER] visits, and hospitalization events), costs, and glycated hemoglobin (HbA1c) over 12 months after discontinuation were evaluated. RESULTS: Overall, 625 of 186,630 patients who discontinued liraglutide during the baseline period (mean [standard deviation (SD)] age, 62.1 [10.1] years) were included in the 12-month analysis. A significant increase in the rate of ER visits (rate ratio [95% confidence interval (CI)]: 1.23 per 100 person-months [1.05, 1.43]; P = 0.0079), hospitalizations (1.36 [1.09, 1.70]; P = 0.0056), and outpatient visits (1.03 [1.01, 1.06]; P = 0.0075) was observed. Total HCRU costs significantly increased after discontinuation ($436.12 per patient per month [$90.07, $782.17]; P = 0.0136), driven by significantly higher outpatient costs ($238.70 [$34.16, $443.25]; P = 0.0223). HbA1c increased significantly by 12 months from mean (SD) 7.37 (1.53) at baseline to 7.63 (1.64; difference: + 0.25 [95% CI 0.14, 0.36]; P < 0.0001). CONCLUSIONS: Patients who discontinued liraglutide showed increases in HCRU; costs, mainly driven by outpatient cost; and HbA1c within 12 months, emphasizing the importance of treatment optimization on clinical and economic outcomes in patients with T2D. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13300-022-01322-z. |
format | Online Article Text |
id | pubmed-9663787 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer Healthcare |
record_format | MEDLINE/PubMed |
spelling | pubmed-96637872022-11-15 Increased Healthcare Resource Use and Costs After Discontinuation of Liraglutide in Patients with Type 2 Diabetes from a Commercial- and Medicaid-Insured Claims Database Uzoigwe, Chioma Noone, Josh Liang, Yuanjie Ali, Sarah Naz Gamble, Cory Diabetes Ther Original Research INTRODUCTION: Liraglutide, a glucagon-like peptide-1 receptor agonist (GLP-1 RA), is effective in patients with type 2 diabetes (T2D), but treatment discontinuation without new T2D therapy initiation may compromise outcomes. METHODS: This retrospective cohort study (July 1, 2012, to December 31, 2019) identified patients ≥ 18 years with T2D in the Optum(®) Clinformatics(®) Data Mart who discontinued liraglutide (index date). Patients with continuous enrollment for ≥ 12 months before and after discontinuation (baseline), ≥ 6 months liraglutide coverage pre-index, and no new T2D therapy start during follow-up were included. Changes from baseline in all-cause healthcare resource utilization (HCRU; outpatient visits, emergency room [ER] visits, and hospitalization events), costs, and glycated hemoglobin (HbA1c) over 12 months after discontinuation were evaluated. RESULTS: Overall, 625 of 186,630 patients who discontinued liraglutide during the baseline period (mean [standard deviation (SD)] age, 62.1 [10.1] years) were included in the 12-month analysis. A significant increase in the rate of ER visits (rate ratio [95% confidence interval (CI)]: 1.23 per 100 person-months [1.05, 1.43]; P = 0.0079), hospitalizations (1.36 [1.09, 1.70]; P = 0.0056), and outpatient visits (1.03 [1.01, 1.06]; P = 0.0075) was observed. Total HCRU costs significantly increased after discontinuation ($436.12 per patient per month [$90.07, $782.17]; P = 0.0136), driven by significantly higher outpatient costs ($238.70 [$34.16, $443.25]; P = 0.0223). HbA1c increased significantly by 12 months from mean (SD) 7.37 (1.53) at baseline to 7.63 (1.64; difference: + 0.25 [95% CI 0.14, 0.36]; P < 0.0001). CONCLUSIONS: Patients who discontinued liraglutide showed increases in HCRU; costs, mainly driven by outpatient cost; and HbA1c within 12 months, emphasizing the importance of treatment optimization on clinical and economic outcomes in patients with T2D. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13300-022-01322-z. Springer Healthcare 2022-10-14 2022-12 /pmc/articles/PMC9663787/ /pubmed/36239850 http://dx.doi.org/10.1007/s13300-022-01322-z Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Original Research Uzoigwe, Chioma Noone, Josh Liang, Yuanjie Ali, Sarah Naz Gamble, Cory Increased Healthcare Resource Use and Costs After Discontinuation of Liraglutide in Patients with Type 2 Diabetes from a Commercial- and Medicaid-Insured Claims Database |
title | Increased Healthcare Resource Use and Costs After Discontinuation of Liraglutide in Patients with Type 2 Diabetes from a Commercial- and Medicaid-Insured Claims Database |
title_full | Increased Healthcare Resource Use and Costs After Discontinuation of Liraglutide in Patients with Type 2 Diabetes from a Commercial- and Medicaid-Insured Claims Database |
title_fullStr | Increased Healthcare Resource Use and Costs After Discontinuation of Liraglutide in Patients with Type 2 Diabetes from a Commercial- and Medicaid-Insured Claims Database |
title_full_unstemmed | Increased Healthcare Resource Use and Costs After Discontinuation of Liraglutide in Patients with Type 2 Diabetes from a Commercial- and Medicaid-Insured Claims Database |
title_short | Increased Healthcare Resource Use and Costs After Discontinuation of Liraglutide in Patients with Type 2 Diabetes from a Commercial- and Medicaid-Insured Claims Database |
title_sort | increased healthcare resource use and costs after discontinuation of liraglutide in patients with type 2 diabetes from a commercial- and medicaid-insured claims database |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9663787/ https://www.ncbi.nlm.nih.gov/pubmed/36239850 http://dx.doi.org/10.1007/s13300-022-01322-z |
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