Treatment Patterns, Adherence, and Persistence Associated With Human Regular U-500 Insulin: A Real-World Evidence Study
Article Figures & Tables
Figures
- FIGURE 1
Persistence; patients who initiated U-500R (top chart) claims in the post-index period who had continued treatment (gray) or had an interruption in treatment (≥60-day gap in claims) (red). The bottom left chart shows the percentages of patients who restarted U-500R and/or initiated a new insulin or who had no new insulin and did not restart U-500R in the follow-up period. The bottom right chart shows the percentages of patients who had continuous treatment or who had a ≥60-day gap in the follow-up period.
- FIGURE 2
Adherence as determined by the percentages of patients by MPR category in the post-index period.
- FIGURE 3
Kaplan-Meier curves for time from U-500R initiation to ≥60-day gap or time from the end of the last-U-500R claim in the post-index period to restart of U-500R by age-groups (<65 and ≥65 years).
- FIGURE 4
Time to restart U-500R after gap (censoring time: from the end of the last U-500R claim in the post-index period to U-500R restart or end of the follow-up period).
Tables
- TABLE 1
Baseline Demographics and Clinical Characteristics
Variable n = 1,582 Men 932 (58.9) Age, years 56.8 ± 9.4 Age-group, years 18–44 152 (9.6) 45–54 438 (27.7) 55–64 703 (44.4) 65–74 243 (15.4) 75–84 43 (2.7) ≥85 3 (0.2) U.S. region North Central 469 (29.6) Northeast 195 (12.3) South 655 (41.4) West 253 (16.1) Unknown/missing 10 (0.6) Insurance Commercial 1,257 (79.5) Medicare 325 (20.5) Deyo-CCI 3.10 ± 2.05 Medical diagnoses Bariatric surgery 1 (0.1) Depression 166 (10.5) Hypertension 1076 (68) Hyperlipidemia 950 (60.1) Hypoglycemia 184 (11.6) Lower-limb amputation 14 (0.9) Neuropathy 568 (35.9) Obesity 354 (22.4)* Nephropathy 423 (26.7) Retinopathy 353 (22.3) Cerebrovascular disease 117 (7.4) CVD, acute myocardial infarction 23 (1.5) CVD, angina 66 (4.2) CVD, coronary 393 (24.8) CVD, heart failure 188 (11.9) CVD, peripheral vascular disease 207 (13.1) CVD, other 67 (4.2) Data are n (%) or mean ± SD. *Obesity is likely underreported in an administrative claims database. CVD, cardiovascular disease.
- TABLE 2
U-500R TDD at First U-500R Claim and at 1 Year or Until a Gap of ≥60 Days Occurred
TDD, units/day First U-500R Claim* 1 Year or Until Gap of ≥60 Days† 0–100 1 (0.1) 0 (0.0) >100–150 61 (3.9) 32 (2.0) >150–200 52 (3.3) 38 (2.4) >200–300 64 (4.0) 122 (7.7) >300 1,404 (88.7) 1,390 (87.9) Data are n (%). *TDD calculated as total units of insulin divided by total day’s supply of the index claim. †TDD calculated as total units of insulin divided by total days’ supply of all claims in the post-index period.
- TABLE 3
Post-Index Overlapping Insulin Use With U-500R
Overlapping of U-500R Claims and Claims for Other Insulins, days N = 1,582. 0 1,172 (74.1) ≥1 410 (25.9) ≥15–29 359 (22.7) ≥30–44 258 (16.3) ≥45–59 148 (9.4) ≥60 120 (7.6) Data are n (%).
- TABLE 4
Concomitant Medication Use by Period
Medication. Pre-Index Period,N = 1,582 Post-Index PeriodN = 1,582 Follow-Up Period,*N = 849 Insulins Intermediate-acting 153 (9.7) 34 (2.1) 40 (4.7) Long-acting 1,205 (76.2) 251 (15.9) 279 (32.9) Premixed 300 (19.0) 30 (1.9) 42 (4.9) Rapid-acting 1,076 (68.0) 185 (11.7) 235 (27.7) Short-acting 122 (7.7) 28 (1.8) 46 (5.4) Any insulin 1,502 (94.9) 418 (26.4) 788 (92.8) Oral glucose-lowering therapies DPP-4 inhibitor 216 (13.7) 90 (5.7) 77 (9.1) Metformin 873 (55.2) 594 (37.5) 367 (43.2) Thiazolidinediones 190 (12.0) 68 (4.3) 47 (5.5) Sulfonylurea 375 (23.7) 111 (7.0) 72 (8.5) SGLT2 inhibitor 3 (0.2) 21 (1.3) 38 (4.5) Any oral glucose-lowering therapies 1,040 (65.7) 704 (44.5) 436 (51.4) Noninsulin injectable therapy Pramlintide 105 (6.6) 61 (3.9) 29 (3.4) GLP-1 RA 172 (10.9) 90 (5.7) 56 (6.6) Any noninsulin injectable 268 (16.9) 149 (9.4) 83 (9.8) Data are n (%). *Patients with gap of ≥60 days in the post-index period. DPP-4, dipeptidyl peptidase-4; GLP-1 RA, glucagon-like peptide 1 receptor agonist.
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