ASSESSING UNMET THERAPEUTIC NEED IN MEDICAID PATIENTS WITH METABOLIC DYSFUNCTION-ASSOCIATED STEATOHEPATITIS (MASH) AND TYPE 2 DIABETES
Author(s)
Kristin Richards, BS, MS, RPh, PhD, Michael Johnsrud, MS, RPh, PhD;
University of Texas at Austin, Austin, TX, USA
University of Texas at Austin, Austin, TX, USA
OBJECTIVES: The overall aim of this study was to assess antidiabetes and cardiovascular medication utilization and adherence among patients with type 2 diabetes (T2D) before and after a new diagnosis for metabolic dysfunction-associated steatohepatitis (MASH).
METHODS: This descriptive, exploratory study utilized Texas Medicaid administrative claims data between 1/2016 and 12/2022. Subjects 18-64 years of age with a T2D diagnosis were included if first evidence of MASH diagnosis occurred between 1/2017 and 12/2021. Continuous enrollment the year before and after initial MASH diagnosis was required. Antidiabetes, antihypertensive, and lipid-lowering medication classes were evaluated. Proportion of days covered (PDC) was used to calculate medication adherence with PDC>0.8 classified as adherent. Multivariable logistic regression was used to assess the odds of adherence to antidiabetes, antihypertensive, and lipid-lowering medications during the post-MASH diagnosis period, controlling for covariates.
RESULTS: Of 2,161 included patients, 73.3% were female, 59.4% were Hispanic, and mean age was 48.3 years. A significantly greater proportion of patients were prescribed antidiabetes, antihypertensive, and lipid-lowering medications in the post-index period compared to the year prior to MASH diagnosis (+1.1, +2.1, +3.7 percentage points; p<0.001). The proportion of patients who were adherent increased by 4.8, 5.0, and 2.6 percentage points, respectively, after MASH diagnosis. Those of older age, male gender, and with hypertension, dyslipidemia, and obesity diagnoses had statically significant higher odds of medication adherence after MASH diagnosis. During the year after MASH diagnosis, 32.5%, 33.1%, and 49.4% of patients had no evidence of utilization of antidiabetes, antihypertensive, or lipid-lowering medications, respectively.
CONCLUSIONS: Our findings indicate that, although there were moderate improvements in medication utilization and adherence, potential unmet need remains with respect to treatment for T2D patients newly-diagnosed with MASH. Interventions that promote weight loss, metabolic disorder management, and medication adherence among patients diagnosed with MASH should be developed and implemented.
METHODS: This descriptive, exploratory study utilized Texas Medicaid administrative claims data between 1/2016 and 12/2022. Subjects 18-64 years of age with a T2D diagnosis were included if first evidence of MASH diagnosis occurred between 1/2017 and 12/2021. Continuous enrollment the year before and after initial MASH diagnosis was required. Antidiabetes, antihypertensive, and lipid-lowering medication classes were evaluated. Proportion of days covered (PDC) was used to calculate medication adherence with PDC>0.8 classified as adherent. Multivariable logistic regression was used to assess the odds of adherence to antidiabetes, antihypertensive, and lipid-lowering medications during the post-MASH diagnosis period, controlling for covariates.
RESULTS: Of 2,161 included patients, 73.3% were female, 59.4% were Hispanic, and mean age was 48.3 years. A significantly greater proportion of patients were prescribed antidiabetes, antihypertensive, and lipid-lowering medications in the post-index period compared to the year prior to MASH diagnosis (+1.1, +2.1, +3.7 percentage points; p<0.001). The proportion of patients who were adherent increased by 4.8, 5.0, and 2.6 percentage points, respectively, after MASH diagnosis. Those of older age, male gender, and with hypertension, dyslipidemia, and obesity diagnoses had statically significant higher odds of medication adherence after MASH diagnosis. During the year after MASH diagnosis, 32.5%, 33.1%, and 49.4% of patients had no evidence of utilization of antidiabetes, antihypertensive, or lipid-lowering medications, respectively.
CONCLUSIONS: Our findings indicate that, although there were moderate improvements in medication utilization and adherence, potential unmet need remains with respect to treatment for T2D patients newly-diagnosed with MASH. Interventions that promote weight loss, metabolic disorder management, and medication adherence among patients diagnosed with MASH should be developed and implemented.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
CO131
Topic
Clinical Outcomes
Topic Subcategory
Clinical Outcomes Assessment
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)