The Association Between Adherence to Insulin Therapy and Health Care Costs for Adults with Type 2 Diabetes: Evidence from a U.S. Retrospective Claims Database

Eby, E.; Bajpai, Shailendra; Faries, Douglas E.; Haynes, Virginia S.; Lage, Maureen J.

doi:10.18553/jmcp.2020.26.9.1081

Cited by 13 publications

(26 citation statements)

References 28 publications

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“…Only full publications reporting data on the associations between adherence/persistence and the clinical/economic outcomes of interest were prioritized for data extraction and are the focus of this manuscript (n = 92). 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 ,…”

Section: Resultsmentioning

confidence: 99%

“…Of the 92 full publications included, 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , ...…”

Section: Resultsunclassified

“…In total, 71 studies included estimates of adherence (cited in Table S3 ). There was variation in how adherence was defined: 30 studies used PDC 22 , 28 , 29 , 30 , 31 , 34 , 36 , 37 , 38 , 39 , 48 , 50 , 56 , 57 , 60 , 63 , 71 , 75 , 76 , 78 , 79 , 80 , 82 , 83 , 85 , 86 , 88 , 98 , 100 , 110 and 26 studies used the MPR. 23 , 29 , 32 , 33 , 35 , 41 , 42 , 44 , 49 , 51 , 53 , 54 , 55 , 64 , 68 , 73 , 77 , 90 , 91 , 95 , 101 , <...…”

Section: Resultsmentioning

confidence: 99%

“…Despite substantial heterogeneity across studies, greater adherence was generally associated with lower inpatient admission costs but higher pharmacy costs. 26,[28][29][30]33,34,39,41,49,72,76,88 Most studies found that total healthcare expenditure in adherent patients was lower than 28,32,39,49,53,54,72,88 or similar to 23,26,34,76 that in nonadherent patients (Figure 2), but in two studies adherence was associated with higher total costs than nonadherence. 30,33 In total, 11 studies reported data on healthcare costs associated with persistence on insulin, 24,25,40,52,61,77,89,96,107 injectable GLP-1RAs 30 and/or combination therapies.…”

Section: Healthcare Costsmentioning

confidence: 99%

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Adherence to and persistence with antidiabetic medications and associations with clinical and economic outcomes in people with type 2 diabetes mellitus: A systematic literature review

Evans

Engberg

Faurby

et al. 2021

Diabetes Obesity Metabolism

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We designed a systematic literature review to identify available evidence on adherence to and persistence with antidiabetic medication in people with type 2 diabetes (T2D). Electronic screening and congress searches identified realworld noninterventional studies (published between 2010 and October 2020) reporting estimates of adherence to and persistence with antidiabetic medication in adults with T2D, and associations with glycaemic control, microvascular and/or macrovascular complications, hospitalizations and healthcare costs.Ninety-two relevant studies were identified, the majority of which were retrospective and reported US data. The proportions of patients considered adherent (median [range] 51.2% [9.4%-84.3%]) or persistent (median [range] 47.7%[16.9%-94.0%]) varied widely across studies. Multiple studies reported an association between greater adherence/persistence and greater reductions in glycated haemoglobin levels. Better adherence/persistence was associated with fewer microvascular and/or macrovascular outcomes, although there was little consistency across studies in terms of which outcomes were improved. More

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Section: Resultsmentioning

confidence: 99%

Section: Resultsunclassified

Section: Resultsmentioning

confidence: 99%

Section: Healthcare Costsmentioning

confidence: 99%

See 2 more Smart Citations

Adherence to and persistence with antidiabetic medications and associations with clinical and economic outcomes in people with type 2 diabetes mellitus: A systematic literature review

Evans

Engberg

Faurby

et al. 2021

Diabetes Obesity Metabolism

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show abstract

“…4 Cost savings have been noted in other studies mainly arising from improved adherence to the treatment. [21][22][23] In our study, everybody on U-500 stayed on treatment after one year of treatment. This is similar to increased adherence to therapy with U-500 noted in other studies.…”

Section: Snmentioning

confidence: 66%

A case series of Humulin R U‐500 in insulin resistant people with type 2 diabetes

et al. 2021

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Humulin R U‐500 has been in use worldwide but is not licensed in the UK. As it is five times concentrated, it has the potential to reduce the number of injections in patients requiring high doses. With the increasing use of U‐200 and U‐300 insulins, glucagon like peptide‐1 (GLP‐1) agonists, pioglitazone and sodium glucose co‐transporter2 (SGLT2) inhibitors, the role of U‐500 insulin is not clear.Ten patients with type 2 diabetes with a mean (SD) daily insulin requirement of 437.70 (112.75) units due to high mean (SD) BMI of 39.05 (4.92) were commenced on U‐500 insulin between November 2013 and August 2020. In this case series the effect on insulin dose, HbA1c, weight, hypoglycaemia and cost was investigated through a review of case notes.Results showed that after one year of treatment the mean (95% CI) HbA1c reduced by 14.5mmol/mol (2.23 to 26.77, p=0.02). Numerically, the mean (95% CI) insulin dose reduced by 57 units (‐36.13 to 150.53), body weight increased by 2.41kg (‐22.37 to 17.55). Self‐reported minor hypoglycaemia increased. There was no severe hypoglycaemia or hospital admission from hypoglycaemia. We calculated a cost saving of £366 per person per year of treatment.It was concluded the use of U‐500 continues to have a role in the management of the severely insulin resistant patient on existing glucose lowering therapy. There is an improvement in HbA1c for the majority of people. Weight gain and hypoglycaemia occurred as a side effect in some people as expected with potent insulin treatment. Copyright © 2021 John Wiley & Sons.

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Addressing the Burden of Multiple Daily Insulin Injections in Type 2 Diabetes with Insulin Pump Technology: A Narrative Review

Brixner,

Edelman,

Sieradzan

et al. 2024

Diabetes Ther

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The growing prevalence of type 2 diabetes (T2D) remains a leading health concern in the US. Despite new medications and technologies, glycemic control in this population remains suboptimal, which increases the risk of poor outcomes, increased healthcare resource utilization, and associated costs. This article reviews the clinical and economic impacts of suboptimal glycemic control in patients on basal-bolus insulin or multiple daily injections (MDI) and discusses how new technologies, such as tubeless insulin delivery devices, referred to as "patch pumps", have the potential to improve outcomes in patients with T2D.

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The Association Between Adherence to Insulin Therapy and Health Care Costs for Adults with Type 2 Diabetes: Evidence from a U.S. Retrospective Claims Database

Abstract: BACKGROUND: Research has shown that many patients with type 2 diabetes (T2D) are not adherent to their medication regimen. OBJECTIVE: To examine the association between adherence to insulin therapy and all-cause health care costs for patients with T2D.

Cited by 13 publications

References 28 publications

Adherence to and persistence with antidiabetic medications and associations with clinical and economic outcomes in people with type 2 diabetes mellitus: A systematic literature review

Adherence to and persistence with antidiabetic medications and associations with clinical and economic outcomes in people with type 2 diabetes mellitus: A systematic literature review

A case series of Humulin R U‐500 in insulin resistant people with type 2 diabetes

Addressing the Burden of Multiple Daily Insulin Injections in Type 2 Diabetes with Insulin Pump Technology: A Narrative Review

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