Electronic Health Records to Rapidly Assess Biosimilar Uptake: An Example Using Insulin Glargine in a Large U.S. Nursing Home Cohort

Abstract

Large healthcare administrative databases, like Medicare claims, are a common means to evaluate drug policies. However, administrative data often have a lag time of months to years before they are available to researchers and decision-makers. Therefore, administrative data are not always ideal for timely policy evaluations. Other sources of data are needed to rapidly evaluate policy changes and inform subsequent studies that utilize large administrative data once available. An emerging area of interest in both pharmacoepidemiology and drug policy research that can benefit from rapid data availability is biosimilar uptake, due to the potential for substantial cost savings. To respond to the need for such a data source, we established a public-private partnership to create a near-real-time database of over 1,000 nursing homes’ electronic health records to describe and quantify the effects of recent policies related to COVID-19 and medications. In this article, we first describe the components and infrastructure used to create our EHR database. Then, we provide an example that illustrates the use of this database by describing the uptake of insulin glargine-yfgn, a new exchangeable biosimilar for insulin glargine, in US nursing homes. We also examine the uptake of all biosimilars in nursing homes before and after the onset of the COVID-19 pandemic. We conclude with potential directions for future research and database infrastructure.

Trends in COVID-19–Related Medication Use in US Nursing Homes, 2018-2022

“…This retrospective cohort study used electronic health records (EHRs) and Minimum Data Set (MDS) resident clinical assessments from 11 different US NH corporations comprising 726 facilities between January 1, 2018, and March 31, 2022. 19 Medication orders in the EHR were used to identify the residents with the use of COVID-related medications. 10 The MDS is a government-mandated assessment for NHs certified by the Centers for Medicare and Medicaid Services that documents resident health information including clinical conditions, functional status, and cognitive status.…”