Medication persistence and its impact on type 2 diabetes.

Publisher: Clinical Care Targeted Communications Group, LLC Country of Publication: United States NLM ID: 9613960 Publication Model: Electronic Cited Medium: Internet ISSN: 1936-2692 (Electronic) Linking ISSN: 10880224 NLM ISO Abbreviation: Am J Manag Care Subsets: MEDLINE

Publication: Cranbury, NJ : Clinical Care Targeted Communications Group, LLC
Original Publication: Old Bridge, NJ : American Medical Pub., c1995-

Diabetes Mellitus, Type 2* ; Medicare Part C*; Adult ; Humans ; Aged ; United States ; Retrospective Studies ; Medication Adherence ; Health Care Costs ; Hypoglycemic Agents/therapeutic use

Objectives: Medication persistence in type 2 diabetes (T2D) is a critical factor for preventing adverse clinical events. We assessed persistence among newly treated patients with T2D and documented the impact of persistence on clinical outcomes and costs.
Study Design: Retrospective study of Optum Clinformatics Data Mart commercial and Medicare Advantage enrollees from 2007 to 2020.
Methods: We identified adult patients who initiated antidiabetic treatments. Patients were required to have at least 1 treatment-free year prior to their first T2D prescription. Persistence was measured as the duration of continuous therapy until a 60-day gap in drug availability appeared in any antidiabetic therapy. Factors associated with duration were documented, focusing on the initial class(es) of T2D drugs. The impact of treatment duration on the risk of hospitalization and on total health care costs was also examined.
Results: A total of 673,265 patients were included, with a median follow-up of 7 years. Only 22% of patients maintained continuous treatment, of whom 10% added a second medication. A 1-month increase in duration was associated with reduced risk of hospitalization due to stroke by 0.54% (95% CI, 0.46%-0.60%), acute myocardial infarction by 0.51% (95% CI, 0.44%-0.57%), and all-cause hospitalization by 0.36% (95% CI, 0.34%-0.37%). A 1-month increase in duration was associated with a year-to-year decrease in medical costs of $51 (95% CI, -$54 to -$48) and an increase in year-to-year drug costs of $14 (95% CI, $13-$14).
Conclusions: Our findings show low persistence among patients with T2D and emphasize the importance of medication persistence, which is associated with cost savings and lower risk of hospitalizations.

0 (Hypoglycemic Agents)

Date Created: 20240411 Date Completed: 20240415 Latest Revision: 20240809

20240809

10.37765/ajmc.2024.89534

38603538