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Type 2 diabetes pharmacotherapy trends in high-risk subgroups.
Jay Bae1, Dongju Liu1, Chanadda Chinthammit1
1Eli Lilly and Company, Indianapolis, Indiana, USA.
Diabetes, Obesity & Metabolism
|March 4, 2022
Summary
Medication use for type 2 diabetes is increasing, but not guided by clinical groups. A gap persists between Commercial and Medicare populations in adopting recommended therapies.
Area of Science:
- Endocrinology and Metabolism
- Pharmacology
- Health Services Research
Background:
- Type 2 diabetes management guidelines, such as the American Diabetes Association (ADA)/European Association for the Study of Diabetes (EASD) consensus report, evolve to recommend specific drug classes.
- Understanding medication use trends in relation to these guidelines is crucial for assessing real-world treatment patterns and identifying disparities.
Purpose of the Study:
- To investigate medication use trends among patients with type 2 diabetes from 2015 to 2019.
- To evaluate medication use in relation to clinical group-specific recommendations from the 2018 ADA/EASD consensus report.
- To compare medication utilization between Commercial and Medicare insurance populations.
Main Methods:
- Analysis of a large health insurance claims database (IBM® MarketScan®) covering Commercial and Medicare populations.
- Examination of medication utilization trends for specific drug classes, including sodium-glucose co-transporter-2 inhibitors and glucagon-like peptide-1 receptor agonists.
- Stratification of analysis by patient characteristics such as obesity, atherosclerotic cardiovascular disease (ASCVD), chronic kidney disease, heart failure, and history of severe hypoglycemia.
Main Results:
- Utilization of sodium-glucose co-transporter-2 inhibitors and glucagon-like peptide-1 receptor agonists increased over time but was consistently lower in the Medicare cohort.
- Patients with obesity received recommended therapies at higher rates than those without.
- Treatment adoption varied by comorbidities, with lower utilization in patients with heart failure, particularly in the Medicare population, and higher adoption in those without ASCVD in the Medicare cohort.
Conclusions:
- Overall utilization of guideline-recommended therapies for type 2 diabetes is increasing.
- Treatment patterns are not preferentially guided by ADA/EASD-defined clinical groups.
- A persistent gap in the utilization of recommended therapies exists between Commercial and Medicare populations.
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