Objectives: Non
-adherence and non
-persistence to anti
-hyperglycemic agents are associated with worse clinical and economic outcomes in patients with type 2 diabetes. This study evaluated treatment persistence and adherence across newer anti
-hyperglycemic agents (canagliflozin, dapagliflozin, sitagliptin, saxagliptin, linagliptin, liraglutide, or exenatide).
Methods: This retrospective cohort study of Truven Health Analytics Marketscan databases included adult patients with type 2 diabetes whose first pharmacy claim for a newer anti
-hyperglycemic agent was between February 1, 2014 and July 31, 2014. Treatment persistence and adherence were assessed for 12 months after the first claim (post-index). Persistence was defined as no gap
≥90 days between the end of one pharmacy claim and the start of the next pharmacy claim post-index. Adherence used two definitions: proportion of days covered (PDC) and medication possession ratio (MPR). Multivariable analyses of non
-persistence (hazard ratios) and adherence (odds ratios) were adjusted for baseline demographics, drug cost, clinical characteristics, and other anti
-hyperglycemic agents.
Results: A total of 11,961 patients met all study selection criteria. Persistence rates at 12 months were significantly greater (
p?0.05 for each comparison) for canagliflozin 100?mg (61%) compared with dapagliflozin 5?mg (40%), dapagliflozin 10?mg (41%), sitagliptin (48%), saxagliptin (42%), linagliptin (52%), liraglutide (47%), exenatide (23%), and long-acting exenatide (39%). The persistence rate was greater (
p?0.05) for canagliflozin 300?mg (64%) vs canagliflozin 100?mg. Median adherence rates for canagliflozin 100?mg (MPR?
=?0.83; PDC?
=?0.79) and canagliflozin 300?mg (MPR?
=?0.92; PDC?
=?0.81) were greater than for the other index anti
-hyperglycemic agents (MPR?
=?0.33
–0.75; PDC?
=?0.33
–0.72). Consistent results for treatment persistence and adherence were observed in multivariable analyses that were adjusted baseline characteristics.
Conclusions: Canagliflozin was associated with better treatment persistence and treatment adherence compared with other anti
-hyperglycemic agents in real-world settings.
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