METHODOLOGICAL CHALLENGES IN CALCULATION OF DAILY AVERAGE CONSUMPTION (DACON) FOR GLP-1 RECEPTOR AGONIST INJECTABLES FROM CLAIMS DATA
Author(s)
Swindle R1, Yu M2, Xie J2
1Eli Lilly and Company, Indianapolis, IN, USA, 2Eli Lilly and Company, Toronto, ON, Canada
OBJECTIVES: This US study aimed to determine average daily dosing of liraglutide from a national payer perspective. METHODS: This study utilized 211,184 liraglutide pharmacy claims from the national Truven MarketScan® Database (10/1/2011-9/30/2012). Patients had type 2 diabetes (DM) diagnoses x 2, no type 1 or gestational DM, and were ≥18 years old (N=56,971). Liraglutide is typically dosed in 1.2 and 1.8 mg/day injections. DACON was based on total daily quantity prescribed (ml x 6 mg/ml ÷ days’ supply). A number of claim quantities and days’ supply values ranged from negative/zero to very high and implausible values, which translated to extremely high daily dose results (skewed distribution). The anomalies were addressed by conducting several analyses. The primary analysis included quantities from 6-27 ml/day and calculated mg/day DACON values as <0.6, 0.6-1.5=1.2, >1.5-2.1=1.8, and >1.8. Sensitivity analyses were conducted for: (A) all values, (B) quantity values “corrected” by corresponding price, (C) quantities corresponding exactly to 1.2 and 1.8 mg/day, (D) quantities with calculated DACONs between 0.6 and 1.8. Additional analyses were performed on excluded patients (N=30,098). RESULTS: On average, patients were 55 years old, 53% female, 60% from PPO plans. Comorbidities included hypertension (48%), cardiovascular disease (11%), obesity (10%), and neuropathy (9%). The DACON for primary analysis was 1.64 (34.4% at 1.2 mg/day; 64.2% at 1.8 mg/day). A sensitivity analysis of all positive claims (A) produced a DACON of 1.97 with 3% of claims >1.8 mg/day; additional DACON analyses were 1.63(B), 1.64(C), and 1.59(D). DACON primary analysis and all-value (A) analyses on liraglutide patients not meeting inclusion criteria were 1.65 and 1.95. CONCLUSIONS: Careful inspection of claims data distributions should guide methods used to arrive at reasonable, compelling findings for analyses even as simple as DACON. Liraglutide’s DACON in use with type 2 DM ranged from 1.59 to 1.64.
Conference/Value in Health Info
2014-05, ISPOR 2014, Palais des Congres de Montreal
Value in Health, Vol. 17, No. 3 (May 2014)
Code
PDB86
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Diabetes/Endocrine/Metabolic Disorders