PMID- 23633415
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20130502
LR  - 20211021
IS  - 2044-6055 (Print)
IS  - 2044-6055 (Electronic)
IS  - 2044-6055 (Linking)
VI  - 3
IP  - 4
DP  - 2013
TI  - Real-world outcomes of US employees with type 2 diabetes mellitus treated with 
      insulin glargine or neutral protamine Hagedorn insulin: a comparative 
      retrospective database study.
LID - 10.1136/bmjopen-2012-002348 [doi]
LID - e002348
AB  - OBJECTIVES: To compare real-world outcomes of initiating insulin glargine (GLA) 
      versus neutral protamine Hagedorn (NPH) insulin among employees with type 2 
      diabetes mellitus (T2DM) who had both employer-sponsored health insurance and 
      short-tem-disability coverages. DESIGN: Retrospective cohort study. SETTING: 
      MarketScan Commercial Claims and Encounters/Health and Productivity Management 
      Databases 2003-2009. PARTICIPANTS: Adult employees with T2DM who were previously 
      treated with oral antidiabetic drugs and/or glucagon-like-peptide 1 receptor 
      agonists and initiated GLA or NPH were included if they were continuously 
      enrolled in healthcare and short-term-disability coverages for 3 months before 
      (baseline) and 1 year after (follow-up) initiation. Treatment selection bias was 
      addressed by 2:1 propensity score matching. Sensitivity analyses were conducted 
      using different matching ratios. PRIMARY AND SECONDARY OUTCOME MEASURES: Outcomes 
      during 1-year follow-up were measured and compared: insulin treatment persistence 
      and adherence; hypoglycaemia rates and daily average consumption of insulin; 
      total and diabetes-specific healthcare resource utilisation and costs and loss in 
      productivity, as measured by short-term disability, and the associated costs. 
      RESULTS: A total of 534 patients were matched and analysed (GLA: 356; NPH 178) 
      with no significant differences in baseline characteristics. GLA patients were 
      more persistent and adherent (both p<0.05), had lower rates of hospitalisation 
      (23% vs 31.4%; p=0.036) and endocrinologist visits (19.1% vs 26.9%; p=0.038), 
      similar hypoglycaemia rates (both 4.4%; p=1.0), higher diabetes drug costs ($2031 
      vs $1522; p<0.001), but similar total healthcare costs ($14 550 vs $16 093; 
      p=0.448) and total diabetes-related healthcare costs ($4686 vs $5604; p=0.416). 
      Short-term disability days and costs were numerically lower in the GLA cohort 
      (16.0 vs 24.5 days; p=0.086 and $2824 vs $4363; p=0.081, respectively). 
      Sensitivity analyses yielded similar findings. CONCLUSIONS: Insulin GLA results 
      in better persistence and adherence, compared with NPH insulin, with no overall 
      cost disadvantages. Better persistence and adherence may lead to long-term health 
      benefits for employees with T2DM.
FAU - Wang, Li
AU  - Wang L
AD  - STATinMED Research, Ann Arbor, Michigan, USA.
FAU - Wei, Wenhui
AU  - Wei W
FAU - Miao, Raymond
AU  - Miao R
FAU - Xie, Lin
AU  - Xie L
FAU - Baser, Onur
AU  - Baser O
LA  - eng
PT  - Journal Article
DEP - 20130430
PL  - England
TA  - BMJ Open
JT  - BMJ open
JID - 101552874
PMC - PMC3641450
EDAT- 2013/05/02 06:00
MHDA- 2013/05/02 06:01
PMCR- 2013/04/30
CRDT- 2013/05/02 06:00
PHST- 2013/05/02 06:00 [entrez]
PHST- 2013/05/02 06:00 [pubmed]
PHST- 2013/05/02 06:01 [medline]
PHST- 2013/04/30 00:00 [pmc-release]
AID - bmjopen-2012-002348 [pii]
AID - 10.1136/bmjopen-2012-002348 [doi]
PST - epublish
SO  - BMJ Open. 2013 Apr 30;3(4):e002348. doi: 10.1136/bmjopen-2012-002348. Print 2013.