PMID- 29547044
OWN - NLM
STAT- MEDLINE
DCOM- 20180524
LR  - 20221207
IS  - 1530-891X (Print)
IS  - 1530-891X (Linking)
VI  - 24
IP  - 3
DP  - 2018 Mar
TI  - HBA1C CONTROL AND COST-EFFECTIVENESS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS 
      INITIATED ON CANAGLIFLOZIN OR A GLUCAGON-LIKE PEPTIDE 1 RECEPTOR AGONIST IN A 
      REAL-WORLD SETTING.
PG  - 273-287
LID - 10.4158/EP-2017-0066 [doi]
AB  - OBJECTIVE: To compare glycated hemoglobin (HbA1c) control and medication costs 
      between patients with type 2 diabetes mellitus (T2DM) treated with canagliflozin 
      300 mg (CANA) or a glucagon-like peptide 1 receptor agonist (GLP-1 RA) in a 
      real-world setting. METHODS: Adults with T2DM newly initiated on CANA or a GLP-1 
      RA (index date) were identified from IQVIA() Real-World Data Electronic Medical 
      Records U.S. database (March 29, 2012-April 30, 2016). Inverse probability of 
      treatment weighting accounted for differences in baseline characteristics. HbA1c 
      levels at 3-month intervals were compared using generalized estimating equations. 
      Medication costs used wholesale acquisition costs. RESULTS: For both cohorts 
      (CANA: n = 11,435; GLP-1 RA: n = 11,582), HbA1c levels decreased at 3 months 
      postindex and remained lower through 30 months. Absolute changes in mean HbA1c 
      from index to 3 months postindex for CANA and GLP-1 RA were -1.16% and -1.21% 
      (patients with baseline HbA1c >/=7% [53 mmol/mol]); -1.54% and -1.51% (patients 
      with baseline HbA1c >/=8% [64 mmol/mol]); and -2.13% and -1.99% (patients with 
      baseline HbA1c >/=9% [75 mmol/mol]), respectively. Postindex, CANA patients with 
      baseline HbA1c >/=7% had similar HbA1c levels at each interval versus GLP-1 RA 
      patients, except 9 months (mean HbA1c, 7.75% [61 mmol/mol] vs. 7.86% [62 
      mmol/mol]; P = .0305). CANA patients with baseline HbA1c >/=8% and >/=9% had 
      consistently lower HbA1c numerically versus GLP-1 RA patients and statistically 
      lower HbA1c at 9 (baseline HbA1c >/=8% or >/=9%), 27, and 30 months (baseline HbA1c 
      >/=9%). Continuous 12-month medication cost $3,326 less for CANA versus GLP-1 RA. 
      CONCLUSION: This retrospective study demonstrated a similar evolution of HbA1c 
      levels among CANA and GLP-1 RA patients in a real-world setting. Lower medication 
      costs suggest CANA is economically dominant over GLP-1 RA (similar effectiveness, 
      lower cost). ABBREVIATIONS: AHA = antihyperglycemic agent BMI = body mass index 
      CANA = canagliflozin 300 mg DCSI = diabetes complications severity index eGFR = 
      estimated glomerular filtration rate EMR = electronic medical record GLP-1 RA = 
      glucagon-like peptide 1 receptor agonist HbA1c = glycated hemoglobin ICD-9-CM = 
      International Classification of Diseases-Ninth Revision-Clinical Modification 
      ICD-10-CM = International Classification of Diseases-Tenth Revision-Clinical 
      Modification IPTW = inverse probability of treatment weighting ITT = 
      intent-to-treat MPR = medication possession ratio PDC = proportion of days 
      covered PS = propensity score PSM = propensity score matching Quan-CCI = 
      Quan-Charlson comorbidity index SGLT2 = sodium-glucose cotransporter 2 T2DM = 
      type 2 diabetes mellitus WAC = wholesale acquisition cost.
FAU - Wysham, Carol H
AU  - Wysham CH
FAU - Pilon, Dominic
AU  - Pilon D
FAU - Ingham, Mike
AU  - Ingham M
FAU - Lafeuille, Marie-Helene
AU  - Lafeuille MH
FAU - Emond, Bruno
AU  - Emond B
FAU - Kamstra, Rhiannon
AU  - Kamstra R
FAU - Pfeifer, Michael
AU  - Pfeifer M
FAU - Lefebvre, Patrick
AU  - Lefebvre P
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Endocr Pract
JT  - Endocrine practice : official journal of the American College of Endocrinology 
      and the American Association of Clinical Endocrinologists
JID - 9607439
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
RN  - 0SAC974Z85 (Canagliflozin)
RN  - 89750-14-1 (Glucagon-Like Peptide 1)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Canagliflozin/economics/*therapeutic use
MH  - Comorbidity
MH  - Cost-Benefit Analysis
MH  - Diabetes Complications/economics/epidemiology
MH  - Diabetes Mellitus, Type 2/blood/*drug therapy/*economics/epidemiology
MH  - Electronic Health Records/statistics & numerical data
MH  - Female
MH  - Glucagon-Like Peptide 1/*agonists
MH  - Glycated Hemoglobin/*metabolism
MH  - Health Care Costs
MH  - Humans
MH  - Hypoglycemic Agents/economics/*therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Young Adult
EDAT- 2018/03/17 06:00
MHDA- 2018/05/25 06:00
CRDT- 2018/03/17 06:00
PHST- 2018/03/17 06:00 [entrez]
PHST- 2018/03/17 06:00 [pubmed]
PHST- 2018/05/25 06:00 [medline]
AID - S1530-891X(20)35743-8 [pii]
AID - 10.4158/EP-2017-0066 [doi]
PST - ppublish
SO  - Endocr Pract. 2018 Mar;24(3):273-287. doi: 10.4158/EP-2017-0066.