PMID- 24293131
OWN - NLM
STAT- MEDLINE
DCOM- 20150408
LR  - 20220330
IS  - 1865-8652 (Electronic)
IS  - 0741-238X (Print)
IS  - 0741-238X (Linking)
VI  - 30
IP  - 12
DP  - 2013 Dec
TI  - The INITIATOR study: pilot data on real-world clinical and economic outcomes in 
      US patients with type 2 diabetes initiating injectable therapy.
PG  - 1128-40
LID - 10.1007/s12325-013-0074-8 [doi]
AB  - INTRODUCTION: Type 2 diabetes mellitus (T2DM) progression often results in 
      treatment intensification with injectable therapy to maintain glycemic control. 
      Using pilot data from the Initiation of New Injectable Treatment Introduced after 
      Anti-diabetic Therapy with Oral-only Regimens study, real-world treatment 
      patterns among T2DM patients initiating injectable therapy with insulin glargine 
      or liraglutide were assessed. METHODS: This was a retrospective analysis of 
      claims from the OptumInsight (OI; January 1, 2010 to July 30, 2010) and 
      HealthCore((R)) (HC; January 1, 2010 to June 1, 2010) health insurance databases. 
      Baseline characteristics, health care resource utilization, and costs were 
      compared between adults with T2DM initiating injectable therapy with insulin 
      glargine pen versus liraglutide. Follow-up outcomes, including glycated 
      hemoglobin A1c (A1C), hypoglycemia, health care utilization, and costs, were 
      assessed. RESULTS: At baseline, almost one in three liraglutide patients (OI, n = 
      363; HC, n = 521) had A1C <7.0%, while insulin glargine patients (OI, n = 498; 
      HC, n = 1,188) had poorer health status, higher A1C (insulin glargine: 9.8% and 
      9.1% versus liraglutide: 7.9% and 7.7%, OI and HC, respectively, both P < 0.001), 
      and were less likely to be obese (insulin glargine: 10.8% and 9.2% versus 
      liraglutide: 17.4% and 18.8%, OI and HC, respectively, both P < 0.01). The 
      percentage of patients experiencing a hypoglycemic event was numerically higher 
      for insulin pen use for both cohorts (OI 4.4% versus 3.0%; HC 6.2% versus 2.3%). 
      During follow-up, in the insulin glargine cohort, annualized diabetes-related 
      costs remained unchanged ($8,344 versus $7,749 OI, and $7,094 versus $7,731 HC), 
      despite a significant increase in pharmacy costs, due to non-significant 
      decreases in medical costs, while the liraglutide cohort had a significant 
      increase in annualized diabetes-related costs ($4,510 versus $7,731 OI, and 
      $4,136 versus $7,111 HC; both P < 0.001) due to a non-significant increase in 
      medical costs coupled with a significant increase in pharmacy costs. CONCLUSION: 
      These descriptive data identified differences in demographic and baseline 
      clinical characteristics among patients initiating injectable therapies. The 
      different health care utilization and cost patterns warrant further 
      cost-effectiveness analysis.
FAU - Thayer, Sarah
AU  - Thayer S
AD  - OptumInsight, Eden Prairie, MN, USA, sarah.thayer@optum.com.
FAU - Wei, Wenhui
AU  - Wei W
FAU - Buysman, Erin
AU  - Buysman E
FAU - Brekke, Lee
AU  - Brekke L
FAU - Crown, William
AU  - Crown W
FAU - Grabner, Michael
AU  - Grabner M
FAU - Raparla, Swetha
AU  - Raparla S
FAU - Quimbo, Ralph
AU  - Quimbo R
FAU - Cziraky, Mark J
AU  - Cziraky MJ
FAU - Hu, Wenli
AU  - Hu W
FAU - Cuddihy, Robert
AU  - Cuddihy R
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20131130
PL  - United States
TA  - Adv Ther
JT  - Advances in therapy
JID - 8611864
RN  - 0 (Blood Glucose)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin, Long-Acting)
RN  - 2ZM8CX04RZ (Insulin Glargine)
RN  - 839I73S42A (Liraglutide)
RN  - 89750-14-1 (Glucagon-Like Peptide 1)
MH  - Adult
MH  - Aged
MH  - Blood Glucose/analysis/*drug effects
MH  - Cohort Studies
MH  - Cost-Benefit Analysis
MH  - Databases, Factual
MH  - Diabetes Mellitus, Type 2/diagnosis/*drug therapy
MH  - Disposable Equipment/economics
MH  - Dose-Response Relationship, Drug
MH  - Drug Administration Schedule
MH  - Female
MH  - Glucagon-Like Peptide 1/administration & dosage/*analogs & derivatives/economics
MH  - *Health Care Costs
MH  - Humans
MH  - Hypoglycemic Agents/administration & dosage/*economics
MH  - Injections, Subcutaneous
MH  - Insulin Glargine
MH  - Insulin, Long-Acting/*administration & dosage/economics
MH  - Liraglutide
MH  - Male
MH  - Middle Aged
MH  - Pilot Projects
MH  - Retrospective Studies
MH  - Severity of Illness Index
MH  - Statistics, Nonparametric
MH  - Syringes/economics
MH  - Treatment Outcome
MH  - United States
PMC - PMC3898354
EDAT- 2013/12/03 06:00
MHDA- 2015/04/09 06:00
PMCR- 2013/11/30
CRDT- 2013/12/03 06:00
PHST- 2013/10/09 00:00 [received]
PHST- 2013/12/03 06:00 [entrez]
PHST- 2013/12/03 06:00 [pubmed]
PHST- 2015/04/09 06:00 [medline]
PHST- 2013/11/30 00:00 [pmc-release]
AID - 74 [pii]
AID - 10.1007/s12325-013-0074-8 [doi]
PST - ppublish
SO  - Adv Ther. 2013 Dec;30(12):1128-40. doi: 10.1007/s12325-013-0074-8. Epub 2013 Nov 
      30.