Comparative persistence and adherence with newer anti-hyperglycemic agents to treat patients with type 2 diabetes in the United States |
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Authors: | Jennifer Cai Yuexi Wang Onur Baser Lin Xie Wing Chow |
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Affiliation: | 1. Janssen Scientific Affairs, LLC, Raritan, NJ, USA;2. STATinMED Research, Ann Arbor, MI, USA;3. Center for Innovation &4. Outcomes Research, Columbia University, New York, NY, USA |
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Abstract: | 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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Keywords: | Diabetes Persistence Adherence SGLT2 DPP-4 GLP-1 Anti-hyperglycemic |
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