Utilization of Oral Hypoglycemic Agents in a Drug-Insured U.S. Population
- Stephen J. Boccuzzi, PHD1,
- Jenifer Wogen, MS1,
- James Fox, MPH1,
- Jennifer C.Y. Sung, PHARMD, MS2,
- Amishi B. Shah, PHARMD3 and
- Jennifer Kim, PHARMD4
- 1The Institute for Effectiveness Research, Bridgewater, New Jersey
- 2Novartis Pharmaceutical Corporation, East Hanover, New Jersey
- 3Department of Pharmaceutical Sciences, Wilkes University, Wilkes-Barre, Pennsylvania
- 4Clinical Economics Research Unit, Georgetown University, Washington, D.C.
Abstract
OBJECTIVE—Clinical trials provide information regarding the safety and efficacy of medications used to manage type 2 diabetes but do not elucidate drug effectiveness in a typical managed care environment. The aim of this study was to characterize “real-world” drug utilization patterns from both a prescriber and a patient perspective.
RESEARCH DESIGN AND METHODS—We conducted a retrospective analysis of a large administrative pharmacy claims database, using data on continuously pharmacy benefit–eligible members prescribed oral hypoglycemic agents (OHAs).
RESULTS—The 12-month persistence rate for the OHA cohort was low, ranging from 31% for α-glucosidase inhibitors to 60% for metformin; compliance rates varied between 70 and 80%. During the first 12 months of therapy, 36% of the patients remaining on therapy at 12 months had one or more therapy modifications. The mean number of therapy changes increased with the length of patient follow-up, with more than half of all patients experiencing at least one therapy change over the duration of follow-up.
CONCLUSIONS—These findings document the wide variation in utilization patterns associated with pharmacological management of type 2 diabetes, suggesting that opportunity exists to optimize its pharmacological management.
- ADA, American Diabetes Association
- AGI, α-glucosidase inhibitor
- OHA, oral hypoglycemic agent
- MMMC, Merck-Medco Managed Care
- SDSD, same drug and same dose
- UKPDS, U.K. Prospective Diabetes Study
Footnotes
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Address correspondence and reprint requests to Stephen J. Boccuzzi, PhD, The Institute for Effectiveness Research L.L.C., 520 US Highway 22 Suite 303, Bridgewater, NJ 08807. E-mail: stephen_boccuzzi{at}mmmc-tier.com.
The Institute for Effectiveness Research is a subsidiary of Merck-Medco Managed Care, a Merck Company.
Received for publication 16 January 2001 and accepted in revised form 10 April 2001.
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
