THERAPEUTIC INERTIA AND HBA1C AMONG ADULTS WITH TYPE 2 DIABETES
Author(s)
Kristina S. Boye, MPH, MS, RPh, PhD1, Moe Lage, PhD2, Vivian T. Thieu, PhD3, Kendra A. Terrell, BS, MPH3.
1Eli Lilly and Company, Greenwood, IN, USA, 2Managing Member, HealthMetrics Outcomes Research, LLC, Branford, CT, USA, 3Eli Lilly and Company, Indianapolis, IN, USA.
1Eli Lilly and Company, Greenwood, IN, USA, 2Managing Member, HealthMetrics Outcomes Research, LLC, Branford, CT, USA, 3Eli Lilly and Company, Indianapolis, IN, USA.
OBJECTIVES: The American Diabetes Association recommends pharmacotherapy generally be initiated upon diagnosis of type 2 diabetes (T2D). This study examines patients’ HbA1c profiles and outcomes among adults diagnosed with T2D and initially untreated with a glucose-lowering agent (GLA).
METHODS: Optum’s de-identified Market Clarity Data (Optum® Market Clarity) database was used to identify 2021-2025 health records of adults with T2D who were untreated with a GLA for at least one-year post-diagnosis. Patient characteristics and diabetes-related resource utilization for the two-year post-period were examined descriptively. Generalized linear models estimated the diabetes-related costs associated with having index HbA1c at or above target (≥7%), relative to index HbA1c below target (<7%).
RESULTS: The study included 8,169 patients newly diagnosed with T2D and untreated with GLA for at least one-year post-diagnosis, representing 40.4% of all newly diagnosed adults with T2D. Of this sample, 51.6% were female with average age 67.2 years (SD=11.9 years), 12.3% had HbA1c ≥7% when initially diagnosed with T2D, and 22.9% were at or above target HbA1c during the two-year post-period. Patients with index HbA1c ≥7% were significantly more likely to have a diabetes-related emergency room visit (5.4% v 2.2%; p<0.0001) and had significantly more diabetes-related office visits (6.9 v 4.3; p<0.0001) in the post-period. Post-period diabetes-related total costs were statistically significantly higher for adults with index HbA1c ≥ 7%, compared to those below target ($8,603 [SD=$4,708] v $7,961 [SD=$4,173]; p<0.0001).
CONCLUSIONS: Despite ADA guidelines, over 40% of patients newly diagnosed with T2D and a recorded HbA1c, were not treated with a GLA for at least one year. Among this group, 22.9% had index HbA1c at or above target in the post-period. Among individuals not initially treated with GLA pharmacotherapy for T2D, index HbA1c ≥ 7% was associated with significantly higher diabetes-related resource utilization and medical costs.
METHODS: Optum’s de-identified Market Clarity Data (Optum® Market Clarity) database was used to identify 2021-2025 health records of adults with T2D who were untreated with a GLA for at least one-year post-diagnosis. Patient characteristics and diabetes-related resource utilization for the two-year post-period were examined descriptively. Generalized linear models estimated the diabetes-related costs associated with having index HbA1c at or above target (≥7%), relative to index HbA1c below target (<7%).
RESULTS: The study included 8,169 patients newly diagnosed with T2D and untreated with GLA for at least one-year post-diagnosis, representing 40.4% of all newly diagnosed adults with T2D. Of this sample, 51.6% were female with average age 67.2 years (SD=11.9 years), 12.3% had HbA1c ≥7% when initially diagnosed with T2D, and 22.9% were at or above target HbA1c during the two-year post-period. Patients with index HbA1c ≥7% were significantly more likely to have a diabetes-related emergency room visit (5.4% v 2.2%; p<0.0001) and had significantly more diabetes-related office visits (6.9 v 4.3; p<0.0001) in the post-period. Post-period diabetes-related total costs were statistically significantly higher for adults with index HbA1c ≥ 7%, compared to those below target ($8,603 [SD=$4,708] v $7,961 [SD=$4,173]; p<0.0001).
CONCLUSIONS: Despite ADA guidelines, over 40% of patients newly diagnosed with T2D and a recorded HbA1c, were not treated with a GLA for at least one year. Among this group, 22.9% had index HbA1c at or above target in the post-period. Among individuals not initially treated with GLA pharmacotherapy for T2D, index HbA1c ≥ 7% was associated with significantly higher diabetes-related resource utilization and medical costs.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE633
Topic
Clinical Outcomes, Economic Evaluation, Real World Data & Information Systems
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity), No Additional Disease & Conditions/Specialized Treatment Areas