Trends in Medicaid Prices, Market Share, and Spending on Long-Acting Insulins, 2006-2018

Hernandez, Inmaculada; Good, Chester B.; Shrank, William H.; Gellad, Walid F.

doi:10.1001/jama.2019.2990

Cited by 26 publications

(23 citation statements)

References 4 publications

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“…As previously hypothesized, differences in child-rearing practices (24), access to and cost of device use (24), individual type 1 diabetes management practices (31), education (31), expectations (32) specific to device use, maternal education level (33), and patient and provider factors (34) may also contribute to the observed difference between the two registries. Cost of insulin is higher in the U.S. than other countries, and this cost continues to increase (35,36). Additionally, out-of-pocket costs associated with some private insurance plans in the U.S. make diabetes technology access cost prohibitive, despite having insurance coverage, and the differential access to care among private payers warrants further studies.…”

Section: Discussionmentioning

confidence: 99%

A Decade of Disparities in Diabetes Technology Use and HbA1c in Pediatric Type 1 Diabetes: A Transatlantic Comparison

et al. 2020

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As diabetes technology use in youth increases worldwide, inequalities in access may exacerbate disparities in hemoglobin A 1c (HbA 1c ). We hypothesized that an increasing gap in diabetes technology use by socioeconomic status (SES) would be associated with increased HbA 1c disparities. RESEARCH DESIGN AND METHODSParticipants aged <18 years with diabetes duration ‡1 year in the Type 1 Diabetes Exchange (T1DX, U.S., n 5 16,457) and Diabetes Prospective Follow-up (DPV, Germany, n 5 39,836) registries were categorized into lowest (Q1) to highest (Q5) SES quintiles. Multiple regression analyses compared the relationship of SES quintiles with diabetes technology use and HbA 1c from 2010-2012 to 2016-2018. RESULTSHbA 1c was higher in participants with lower SES (in 2010-2012 and 2016-2018, respectively: 8.0% and 7.8% in Q1 and 7.6% and 7.5% in Q5 for DPV; 9.0% and 9.3% in Q1 and 7.8% and 8.0% in Q5 for T1DX). For DPV, the association between SES and HbA 1c did not change between the two time periods, whereas for T1DX, disparities in HbA 1c by SES increased significantly (P < 0.001). After adjusting for technology use, results for DPV did not change, whereas the increase in T1DX was no longer significant. CONCLUSIONSAlthough causal conclusions cannot be drawn, diabetes technology use is lowest and HbA 1c is highest in those of the lowest SES quintile in the T1DX, and this difference for HbA 1c broadened in the past decade. Associations of SES with technology use and HbA 1c were weaker in the DPV registry.

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Section: Discussionmentioning

confidence: 99%

A Decade of Disparities in Diabetes Technology Use and HbA1c in Pediatric Type 1 Diabetes: A Transatlantic Comparison

et al. 2020

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“…10 A review of Medicaid state drug use data of long-acting insulin products suggests that when BGlar entered the market in late 2015, the reimbursement rate for LGlar, which had been increasing by 13% since 2006, finally declined. 11 It is reasonable to expect additional savings once clinical practitioners accept these insulin biosimilars as "interchangeable." 11 Our findings suggest that prescription drug expenditures can be lowered with BGlar versus LGlar, without compromising efficacy.…”

Section: Discussionmentioning

confidence: 99%

Real-World Evaluation of Dosing in Patients Converted From Insulin Glargine (Lantus) to Insulin Glargine (Basaglar)

et al. 2020

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Background: Basaglar, insulin glargine (BGlar; Eli Lilly, Indianapolis, IN), a follow-on biologic, was developed after the patent for Lantus, insulin glargine (LGlar; Sanofi-Aventis, Paris, France) expired. Objective: To compare the dosing and hemoglobin A1C (A1C)-lowering effects of BGlar compared with LGlar in a real-world setting. Methods: Adult patients, at 5 clinics, with type 1 (T1DM) or type 2 diabetes mellitus (T2DM) who were converted from LGlar to BGlar were included in this retrospective observational study. The primary outcome compared mean basal insulin dose (U/d) from the date of conversion to 6 months. Basal insulin and total daily insulin doses were also compared from baseline to 3- and 12-months postconversion, as also change in A1C, body weight, and estimated monthly acquisition costs of basal insulin. Results: Of the 225 patients included, 56% were male, and 81% had T2DM. The mean conversion dose (U/d) of LGlar was 46.3 ± 32.7. There was no significant difference in the mean BGlar dose (U/d) at 6 months (45.9 ± 33.5; P = 0.52), nor was there a statistical difference at 3 or 12 months. There were no significant differences in change in A1C at any time point. The estimated monthly acquisition cost of BGlar was significantly less than that for LGlar at conversion ($286 vs $341, P < 0.001) and 6 months ($290 vs $351, P < 0.001) respectively. Conclusion/Relevance: The results of this retrospective study suggest that BGlar resulted in similar glycemic outcomes compared with LGlar in a real-world setting and may be a preferable option in a value-based health care environment.

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“…A motivation for other insulin manufacturer to get their insulins approved as BioIns in the United States market is the good market success of the Eli Lilly/Boehringer Ingelheim insulin (Basaglar non-European countries and Abasaglar in Europe) (12). However, it has not gained so much market uptake in the European Union (EU).…”

Section: Biosimilar Insulinmentioning

confidence: 99%

New Insulins, Biosimilars, and Insulin Therapy

Danne

Heinemann²,

Bolinder

2020

Diabetes Technology & Therapeutics

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Trends in Medicaid Prices, Market Share, and Spending on Long-Acting Insulins, 2006-2018

Cited by 26 publications

References 4 publications

A Decade of Disparities in Diabetes Technology Use and HbA1c in Pediatric Type 1 Diabetes: A Transatlantic Comparison

A Decade of Disparities in Diabetes Technology Use and HbA1c in Pediatric Type 1 Diabetes: A Transatlantic Comparison

Real-World Evaluation of Dosing in Patients Converted From Insulin Glargine (Lantus) to Insulin Glargine (Basaglar)

New Insulins, Biosimilars, and Insulin Therapy

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