Mehul R Dalal1, Michael Grabner2, Nicole Bonine3, Judith J Stephenson2, Andres DiGenio4, Nella Bieszk5. 1. Millennium Pharmaceuticals, a wholly-owned subsidiary of Takeda Pharmaceuticals Inc., Cambridge, MA, USA. Electronic address: Mehul.dalal@Takeda.com. 2. Healthcore Inc., Wilmington, DE, USA. 3. OptumRx, Irvine, CA, USA. 4. Akcea Therapeutics, Cambridge, MA, USA. 5. Sanofi US, Inc., Bridgewater, NJ, USA.
Abstract
AIMS: To investigate treatment patterns and achievement of glycemic targets in patients with type 2 diabetes mellitus treated with basal insulin in a real-world setting, and to determine physicians' beliefs and practices regarding these patients. METHODS: This study had two components; a retrospective analysis using a US claims database of patient and treatment data, and a survey of physicians' beliefs and practices. RESULTS: A total of 39,074 patients treated with basal insulin were included in this analysis. The proportion of patients achieving HbA1c<7.0% (53mmol/mol) was similar in ongoing basal insulin users at baseline (26%) and at 3months follow-up (27%). The number of new initiators achieving HbA1c<7.0% (53mmol/mol) increased from baseline (11%) to 3months (27%). In the physician survey component, the majority of physicians indicated they would continue to increase basal insulin dose as long as was needed to reach HbA1c/fasting blood glucose goals (85% of physicians treating 'not on-goal' patients, 78% of physicians treating 'on-goal' patients). Physician-perceived barriers to insulin intensification included patient's lifestyle, non-adherence, and concerns about out-of-pocket costs. CONCLUSIONS: A large proportion of patients on insulin-based therapy fail to reach glycemic goals. More education of clinicians may improve insulin intensification rates and increase the proportion of patients reaching glycemic targets.
AIMS: To investigate treatment patterns and achievement of glycemic targets in patients with type 2 diabetes mellitus treated with basal insulin in a real-world setting, and to determine physicians' beliefs and practices regarding these patients. METHODS: This study had two components; a retrospective analysis using a US claims database of patient and treatment data, and a survey of physicians' beliefs and practices. RESULTS: A total of 39,074 patients treated with basal insulin were included in this analysis. The proportion of patients achieving HbA1c<7.0% (53mmol/mol) was similar in ongoing basal insulin users at baseline (26%) and at 3months follow-up (27%). The number of new initiators achieving HbA1c<7.0% (53mmol/mol) increased from baseline (11%) to 3months (27%). In the physician survey component, the majority of physicians indicated they would continue to increase basal insulin dose as long as was needed to reach HbA1c/fasting blood glucose goals (85% of physicians treating 'not on-goal' patients, 78% of physicians treating 'on-goal' patients). Physician-perceived barriers to insulin intensification included patient's lifestyle, non-adherence, and concerns about out-of-pocket costs. CONCLUSIONS: A large proportion of patients on insulin-based therapy fail to reach glycemic goals. More education of clinicians may improve insulin intensification rates and increase the proportion of patients reaching glycemic targets.
Authors: Michael Joubert; Pierre-Yves Benhamou; Pauline Schaepelynck; Hélène Hanaire; Bogdan Catargi; Anne Farret; Pierre Fontaine; Bruno Guerci; Yves Reznik; Nathalie Jeandidier; Alfred Penfornis; Sophie Borot; Lucy Chaillous; Sylvia Franc; Pierre Serusclat; Yacine Kherbachi; Eric Bavière; Bruno Detournay; Pierre Simon; Guillaume Charpentier Journal: J Diabetes Sci Technol Date: 2019-03-12
Authors: Mark J Cziraky; Scott Abbott; Matt Nguyen; Kay Larholt; Elizabeth Apgar; Thomas Wasser; Poul Strange; Leon Shi; H Courtenay Harrison; Beverly Everitt; Lynn Nowak Journal: J Health Econ Outcomes Res Date: 2019-03-27