DRUG UTILIZATION STUDY IN PATIENTS WITH TYPE 2 DIABETES MELLITUS IN AN ITALIAN REAL-WORLD SETTING- A RETROSPECTIVE STUDY.
Author(s)
Degli Esposti L1, Perrone V1, Saragoni S1, Blini V1, D'Avella R2, Gasperini G3, Lena F4, Fanelli F5, Gazzi L5, Giorgino F6
1CliCon S.r.l. Health, Economics & Outcomes Research, Ravenna, Italy, 2Complex Operation Unit - Pharmaceutical Department,Toscana Sud Est Local Health Unit, Arezzo, Italy, 3Complex Operation Unit of Hospital Pharmacy for Hospital of Siena -Territory Continuity of care, Toscana Sud Est Local Health Unit, siena, Italy, 4Local Health Unit - Pharmaceutical Department of Grosseto, Toscana Sud Est Local Health Unit, Grosseto, Italy, 5Sanofi, Milan, Italy, 6Department of Emergency and Organ Transplantation, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, Bari, Italy
OBJECTIVES: This study aimed at estimating the prevalence of Type 2 Diabetes (T2DM) patients treated with basal insulin, and evaluating daily insulin dose, treatment patterns and adherence to treatment of these patients.METHODS: Administrative and laboratory databases of 3 Italian Local Health Units were retrospectively analyzed. All patients with a diagnosis of T2DM between January 2012 and December 2012 were considered; of those, patients with at least a prescription of insulin glargine 100 U/mL (Gla-100) between 01/01/2013 and 31/12/2014 were included, based on an individual index date (date of the first prescription of insulin), followed-up for one year. Antidiabetes medications and prior pharmacological treatments were assessed, as well as HbA1c levels at baseline and during the follow-up period. For each patient, we calculated the daily average dose of insulin and medication adherenceRESULTS: A total of 54,385 patients had a diagnosis of T2DM, of those, 7,422 met the inclusion criteria. According to the treatment assigned, our cohort was characterized into Gla-100, Gla-100 plus other oral glucose-lowering drugs, Gla-100 plus rapid-acting insulin and Gla-100 plus DPP-4 inhibitors patients. Patients initiating Gla-100 plus DPP-4 inhibitors after index date were younger than other patients’ cohort (67.7±10.0 years) and more likely suffered from hypertension and dyslipidemia (77.0%). Median daily dose of insulin among Gla-100 only patients was higher than other groups (35 IU, about 20 IU in the other groups), and a higher percentage of them achieved glycemic target (53.8% compared to about 30% of the other groups). Whereas, adherence to insulin treatment was higher (64.4%) in Gla-100 plus DPP-4 inhibitors compared to other groups. CONCLUSIONS: A significant proportion of patients with diagnosis of T2DM and treated with insulin failed in achieving glycemic targets; moreover, adherence to anti-diabetes medications was suboptimal. Non-adherent T2DM patients should be further characterized in order to improve long-term outcomes.
Conference/Value in Health Info
2018-11, ISPOR Europe 2018, Barcelona, Spain
Value in Health, Vol. 21, S3 (October 2018)
Code
PDB114
Topic
Patient-Centered Research
Topic Subcategory
Adherence, Persistence, & Compliance
Disease
Diabetes/Endocrine/Metabolic Disorders
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