PMID- 29663262
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 1869-6953 (Print)
IS  - 1869-6961 (Electronic)
IS  - 1869-6961 (Linking)
VI  - 9
IP  - 3
DP  - 2018 Jun
TI  - Characteristics, Treatment Patterns, and Economic Outcomes of Patients Initiating 
      Injectable Medications for Management of Type 2 Diabetes Mellitus in Japan: 
      Results from a Retrospective Claims Database Analysis.
PG  - 1125-1141
LID - 10.1007/s13300-018-0407-3 [doi]
AB  - INTRODUCTION: This study's objective was to describe characteristics, treatment 
      patterns, and economic outcomes of type 2 diabetes mellitus (T2DM) patients 
      initiating injectable antidiabetic medications in Japan. METHODS: Adults 
      (>/= 18 years) with T2DM, >/= 2 claims for injectable antidiabetics between 1 August 
      2011 and 31 July 2015 (first claim = index date), no evidence of type 1 diabetes 
      mellitus, </= 1 claim for insulin, no claims for GLP-1RA before index, and 
      continuous enrollment for 6 months before (baseline) and 12 months after index 
      (follow-up) were selected from the Japan Medical Center Database. Patient 
      characteristics and outcomes during the baseline and follow-up periods were 
      described overall and by provider, using the proxy setting of index medication 
      [hospital (including outpatient departments) for specialists; clinic for general 
      practitioner (GP)]. RESULTS: Of the 2683 patients included (mean age: 50 years, 
      67% male), 1879 (70%) initiated injectable antidiabetics with specialists and 804 
      (30%) with GPs. The specialist cohort had a significantly greater comorbidity 
      burden, but lower HbA1c levels during baseline, and was more likely to receive 
      intensified treatment at index than the GP cohort. Almost 40% of patients (almost 
      30% of GP cohort) did not use antidiabetics during baseline; the remaining 
      patients received oral medications, primarily from GPs. During follow-up, 
      patients used the index medication for approximately 7 months. Independent of 
      specialist vs. GP setting, patients received antidiabetics and medications for 
      T2DM-related comorbidities and complications during the baseline and follow-up 
      periods from the same provider, primarily GPs. The overall average healthcare 
      costs were  yen350,404 during baseline and  yen1,856,727 during follow-up. CONCLUSIONS: 
      In Japan, most T2DM patients initiated injectable antidiabetics with specialists 
      vs. GPs. There were considerable differences in characteristics of patients 
      treated by specialists vs. GPs. After initiation, injectable antidiabetics were 
      largely prescribed by GPs. Future research should evaluate the factors associated 
      with different provider practices and communication channels between specialists 
      and GPs to improve patient management. FUNDING: Eli Lilly and Co.
FAU - Suzuki, Shuichi
AU  - Suzuki S
AD  - Eli Lilly Japan, K.K., Kobe, Japan. Suzuki_shuichi@lilly.com.
FAU - Desai, Urvi
AU  - Desai U
AD  - Analysis Group, Inc., Boston, MA, USA.
FAU - Strizek, Alena
AU  - Strizek A
AD  - Eli Lilly and Company, Indianapolis, IN, USA.
FAU - Ivanova, Jasmina
AU  - Ivanova J
AD  - Analysis Group, Inc., New York, NY, USA.
FAU - Garcia-Horton, Viviana
AU  - Garcia-Horton V
AD  - Analysis Group, Inc., New York, NY, USA.
FAU - Cai, Zhihong
AU  - Cai Z
AD  - Eli Lilly Japan, K.K., Kobe, Japan.
FAU - Schmerold, Luke
AU  - Schmerold L
AD  - Analysis Group, Inc., New York, NY, USA.
FAU - Liu, Xinyue
AU  - Liu X
AD  - Analysis Group, Inc., New York, NY, USA.
FAU - Perez-Nieves, Magaly
AU  - Perez-Nieves M
AD  - Eli Lilly and Company, Indianapolis, IN, USA.
LA  - eng
PT  - Journal Article
DEP - 20180416
PL  - United States
TA  - Diabetes Ther
JT  - Diabetes therapy : research, treatment and education of diabetes and related 
      disorders
JID - 101539025
PMC - PMC5984911
OTO - NOTNLM
OT  - Costs
OT  - Injectable antidiabetic
OT  - Resource use
OT  - Specialist vs. GP setting
OT  - Treatment patterns
OT  - Type 2 diabetes
EDAT- 2018/04/18 06:00
MHDA- 2018/04/18 06:01
PMCR- 2018/04/16
CRDT- 2018/04/18 06:00
PHST- 2018/01/11 00:00 [received]
PHST- 2018/04/18 06:00 [pubmed]
PHST- 2018/04/18 06:01 [medline]
PHST- 2018/04/18 06:00 [entrez]
PHST- 2018/04/16 00:00 [pmc-release]
AID - 10.1007/s13300-018-0407-3 [pii]
AID - 407 [pii]
AID - 10.1007/s13300-018-0407-3 [doi]
PST - ppublish
SO  - Diabetes Ther. 2018 Jun;9(3):1125-1141. doi: 10.1007/s13300-018-0407-3. Epub 2018 
      Apr 16.