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ORLANDO – Most patients with type 2 diabetes mellitus stop taking their medication within a year, and nearly one-third stop within the first 3 months, a retrospective analysis of claims data for more than 324,000 patients suggests.
The findings in this population of commercially insured adults are startling and highlight a need for interventions to improve treatment persistence, according to Lisa Latts, MD, deputy chief health officer for IBM Watson Health in Cambridge, Mass.
Dr. Latts and her colleagues reviewed medication claims data for 324,136 patients with at least one diagnosis for type 2 diabetes mellitus and one outpatient pharmacy claim for a type 2 diabetes medication after at least 12 prior months without such a claim.
Of those patients, 58% discontinued treatment within 12 months, 31% discontinued within the first 3 months, and 44% discontinued within 6 months, Dr. Latts reported at the annual scientific sessions of the American Diabetes Association.
“Less than half of those patients who discontinued had a restart within the following year. So what we’re seeing here is a huge percentage of individuals who had a diagnosis of type 2 diabetes, were prescribed a medication, and then did not continue the medication,” she said.
Of those who discontinued within the 12-month follow-up, 27% restarted therapy within 60 days and 39% restarted therapy anytime during the 12-month follow-up (mean treatment gap, 107 days). Of those who discontinued by 3 months, 45% restarted within a year (mean treatment gap, 112 days), and of those who discontinued by 6 months, 44% restarted within a year (mean treatment gap, 119 days).
Patients included in the review, which was a collaborative effort of IBM Watson Health and the ADA, had at least 12 months of continuous enrollment in the Truven Health MarketScan Commercial and Medicare Supplemental Databases between 2013 and 2017, before and after the therapy initiation date.
They had a mean age of 55 years, with 28% aged 45-54 years and 35% aged 55-64 years. About 46% were women, and all had at least one diagnosis for type 2 diabetes mellitus during the study period and at least one outpatient pharmacy claim for a type 2 diabetes medication that was prescribed to be taken for at least 30 days.
“As you would expect, far and away the majority [68%] were given metformin,” Dr. Latts said.
Other prescribed treatments after the initial diagnosis included sulfonylureas (7%), insulin (6%), dipeptidyl peptidase–4 inhibitors (6%), sodium-glucose cotransporter 2 inhibitors (1.5%), and a variety of combination treatments – typically metformin plus sulfonylureas (5%).
This study provides real-world evidence that a majority of patients with type 2 diabetes discontinue their treatment within 1 year – an important finding given that medication persistence is imperative for successful treatment, Dr. Latts said. She noted that prior research has shown treatment discontinuation of prescribed medication within the first year is common for a number of chronic disease treatments and is associated with poor clinical outcomes.
“If you treat diabetes, this is alarming,” she said. “These are people who should be on a diabetes med, their doctor probably thinks they’re on a diabetes med, and they’re not taking it.”
The findings are limited by factors associated with the use of administrative claims data, such as possible coding inaccuracies and missed cases in which patients paid out of pocket for medications through low-cost pharmacy offers, as well as by the 12-month window used for the study. She added that the findings may not be generalizable to uninsured or Medicare patients.
Nevertheless, the findings are concerning and may reflect misunderstandings among patients about the need to refill prescriptions after the initial supply runs out, or may relate to side effects that patients don’t report to their physicians, Sherita Golden, MD, of Johns Hopkins University, Baltimore, said during a question-and-answer period following Dr. Latts’ presentation.
“I do treat patients with diabetes so I am very alarmed,” she said, adding that there is a need to improve communication between patients and physicians about treatment and side effects.
Dr. Latts reported relationships with Medtronic, Novo Nordisk, and Sanofi. Her coauthors from IBM Watson and the ADA all reported having no financial disclosures.
SOURCE: Latts L et al. ADA 2018, Abstract 135-OR.
ORLANDO – Most patients with type 2 diabetes mellitus stop taking their medication within a year, and nearly one-third stop within the first 3 months, a retrospective analysis of claims data for more than 324,000 patients suggests.
The findings in this population of commercially insured adults are startling and highlight a need for interventions to improve treatment persistence, according to Lisa Latts, MD, deputy chief health officer for IBM Watson Health in Cambridge, Mass.
Dr. Latts and her colleagues reviewed medication claims data for 324,136 patients with at least one diagnosis for type 2 diabetes mellitus and one outpatient pharmacy claim for a type 2 diabetes medication after at least 12 prior months without such a claim.
Of those patients, 58% discontinued treatment within 12 months, 31% discontinued within the first 3 months, and 44% discontinued within 6 months, Dr. Latts reported at the annual scientific sessions of the American Diabetes Association.
“Less than half of those patients who discontinued had a restart within the following year. So what we’re seeing here is a huge percentage of individuals who had a diagnosis of type 2 diabetes, were prescribed a medication, and then did not continue the medication,” she said.
Of those who discontinued within the 12-month follow-up, 27% restarted therapy within 60 days and 39% restarted therapy anytime during the 12-month follow-up (mean treatment gap, 107 days). Of those who discontinued by 3 months, 45% restarted within a year (mean treatment gap, 112 days), and of those who discontinued by 6 months, 44% restarted within a year (mean treatment gap, 119 days).
Patients included in the review, which was a collaborative effort of IBM Watson Health and the ADA, had at least 12 months of continuous enrollment in the Truven Health MarketScan Commercial and Medicare Supplemental Databases between 2013 and 2017, before and after the therapy initiation date.
They had a mean age of 55 years, with 28% aged 45-54 years and 35% aged 55-64 years. About 46% were women, and all had at least one diagnosis for type 2 diabetes mellitus during the study period and at least one outpatient pharmacy claim for a type 2 diabetes medication that was prescribed to be taken for at least 30 days.
“As you would expect, far and away the majority [68%] were given metformin,” Dr. Latts said.
Other prescribed treatments after the initial diagnosis included sulfonylureas (7%), insulin (6%), dipeptidyl peptidase–4 inhibitors (6%), sodium-glucose cotransporter 2 inhibitors (1.5%), and a variety of combination treatments – typically metformin plus sulfonylureas (5%).
This study provides real-world evidence that a majority of patients with type 2 diabetes discontinue their treatment within 1 year – an important finding given that medication persistence is imperative for successful treatment, Dr. Latts said. She noted that prior research has shown treatment discontinuation of prescribed medication within the first year is common for a number of chronic disease treatments and is associated with poor clinical outcomes.
“If you treat diabetes, this is alarming,” she said. “These are people who should be on a diabetes med, their doctor probably thinks they’re on a diabetes med, and they’re not taking it.”
The findings are limited by factors associated with the use of administrative claims data, such as possible coding inaccuracies and missed cases in which patients paid out of pocket for medications through low-cost pharmacy offers, as well as by the 12-month window used for the study. She added that the findings may not be generalizable to uninsured or Medicare patients.
Nevertheless, the findings are concerning and may reflect misunderstandings among patients about the need to refill prescriptions after the initial supply runs out, or may relate to side effects that patients don’t report to their physicians, Sherita Golden, MD, of Johns Hopkins University, Baltimore, said during a question-and-answer period following Dr. Latts’ presentation.
“I do treat patients with diabetes so I am very alarmed,” she said, adding that there is a need to improve communication between patients and physicians about treatment and side effects.
Dr. Latts reported relationships with Medtronic, Novo Nordisk, and Sanofi. Her coauthors from IBM Watson and the ADA all reported having no financial disclosures.
SOURCE: Latts L et al. ADA 2018, Abstract 135-OR.
ORLANDO – Most patients with type 2 diabetes mellitus stop taking their medication within a year, and nearly one-third stop within the first 3 months, a retrospective analysis of claims data for more than 324,000 patients suggests.
The findings in this population of commercially insured adults are startling and highlight a need for interventions to improve treatment persistence, according to Lisa Latts, MD, deputy chief health officer for IBM Watson Health in Cambridge, Mass.
Dr. Latts and her colleagues reviewed medication claims data for 324,136 patients with at least one diagnosis for type 2 diabetes mellitus and one outpatient pharmacy claim for a type 2 diabetes medication after at least 12 prior months without such a claim.
Of those patients, 58% discontinued treatment within 12 months, 31% discontinued within the first 3 months, and 44% discontinued within 6 months, Dr. Latts reported at the annual scientific sessions of the American Diabetes Association.
“Less than half of those patients who discontinued had a restart within the following year. So what we’re seeing here is a huge percentage of individuals who had a diagnosis of type 2 diabetes, were prescribed a medication, and then did not continue the medication,” she said.
Of those who discontinued within the 12-month follow-up, 27% restarted therapy within 60 days and 39% restarted therapy anytime during the 12-month follow-up (mean treatment gap, 107 days). Of those who discontinued by 3 months, 45% restarted within a year (mean treatment gap, 112 days), and of those who discontinued by 6 months, 44% restarted within a year (mean treatment gap, 119 days).
Patients included in the review, which was a collaborative effort of IBM Watson Health and the ADA, had at least 12 months of continuous enrollment in the Truven Health MarketScan Commercial and Medicare Supplemental Databases between 2013 and 2017, before and after the therapy initiation date.
They had a mean age of 55 years, with 28% aged 45-54 years and 35% aged 55-64 years. About 46% were women, and all had at least one diagnosis for type 2 diabetes mellitus during the study period and at least one outpatient pharmacy claim for a type 2 diabetes medication that was prescribed to be taken for at least 30 days.
“As you would expect, far and away the majority [68%] were given metformin,” Dr. Latts said.
Other prescribed treatments after the initial diagnosis included sulfonylureas (7%), insulin (6%), dipeptidyl peptidase–4 inhibitors (6%), sodium-glucose cotransporter 2 inhibitors (1.5%), and a variety of combination treatments – typically metformin plus sulfonylureas (5%).
This study provides real-world evidence that a majority of patients with type 2 diabetes discontinue their treatment within 1 year – an important finding given that medication persistence is imperative for successful treatment, Dr. Latts said. She noted that prior research has shown treatment discontinuation of prescribed medication within the first year is common for a number of chronic disease treatments and is associated with poor clinical outcomes.
“If you treat diabetes, this is alarming,” she said. “These are people who should be on a diabetes med, their doctor probably thinks they’re on a diabetes med, and they’re not taking it.”
The findings are limited by factors associated with the use of administrative claims data, such as possible coding inaccuracies and missed cases in which patients paid out of pocket for medications through low-cost pharmacy offers, as well as by the 12-month window used for the study. She added that the findings may not be generalizable to uninsured or Medicare patients.
Nevertheless, the findings are concerning and may reflect misunderstandings among patients about the need to refill prescriptions after the initial supply runs out, or may relate to side effects that patients don’t report to their physicians, Sherita Golden, MD, of Johns Hopkins University, Baltimore, said during a question-and-answer period following Dr. Latts’ presentation.
“I do treat patients with diabetes so I am very alarmed,” she said, adding that there is a need to improve communication between patients and physicians about treatment and side effects.
Dr. Latts reported relationships with Medtronic, Novo Nordisk, and Sanofi. Her coauthors from IBM Watson and the ADA all reported having no financial disclosures.
SOURCE: Latts L et al. ADA 2018, Abstract 135-OR.
REPORTING FROM ADA 2018
Key clinical point:
Major finding: In total, 58% of patients discontinued treatment within 12 months, and just 39% of those patients restarted within 1 year.
Study details: An analysis of claims data for more than 324,000 patients.
Disclosures: Dr. Latts reported relationships with Medtronic, Novo Nordisk, and Sanofi. Her coauthors from IBM Watson and the American Diabetes Association all reported having no financial disclosures.
Source: Latts L et al. ADA 2018, Abstract 135-OR.