Retrospective Study of Adherence to Glucagon-like Peptide-1 Receptor Agonist Therapy in Patients with Type 2 Diabetes Mellitus in the United States

Johnston, Stephen S.; Nguyen, Hannah; Felber, Eugene; Cappell, Katherine; Nelson, J.W.; Chu, Bong-Chul; Kalsekar, Iftekhar

doi:10.1007/s12325-014-0166-0

Cited by 65 publications

(71 citation statements)

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“…A third US claims data analysis compared adherence between BID, OD and once-weekly therapy with GLP-1 receptor agonists. It reported a higher unadjusted MPR for once-weekly therapy (78.3%), compared to BID (50.0%) or OD therapy (68.3–76.1% depending on dosage) [23]. The only known European-based study which analyzed adherence/persistence to therapy with GLP-1 receptor agonists reported a 12-month therapy discontinuation rate of 32.2% to BID treatment [27].…”

Section: Discussionmentioning

confidence: 99%

“…Much less is known about the level of persistence/adherence to therapy with GLP-1 receptor agonists. Three previous US analyses reported 12-month medication possession ratios (MPRs) of 68% for BID GLP-1 [21], 69.7% for OD GLP-1 and 64.4% for BID GLP-1 [22], or 78.3% for once-weekly GLP-1, compared to 50.0% for BID GLP-1 and 68.3–76.1% for OD GLP-1 [23], the only known European-based study reported a 12-month therapy discontinuation rate of 32.2% for BID therapy with GLP-1 receptor agonists only [24]. Consequently, there is limited real-world data from European T2DM patients about the persistence and adherence to therapy with GLP-1 receptor agonists.…”

Section: Introductionmentioning

confidence: 99%

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Non-Persistence and Non-Adherence of Patients with Type 2 Diabetes Mellitus in Therapy with GLP-1 Receptor Agonists: A Retrospective Analysis

et al. 2015

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IntroductionOur main aim was to assess the level of persistence and adherence to therapy with glucagon-like peptide-1 (GLP-1) receptor agonists in type 2 diabetes mellitus (T2DM) patients in the United Kingdom (UK) and Germany, also by comparing once- (OD) with twice-a-day (BID) therapy.MethodsWe used two large retrospective datasets: a German claims dataset and the UK General Practitioner (GP)-based Clinical Practice Research Datalink (CPRD) dataset (2010–2012). All continuously insured T2DM patients with at least one outpatient/inpatient T2DM diagnosis were observed starting with the first prescription of a GLP-1 receptor agonist. Non-persistence (NP) was defined as treatment gap >90 days. Non-adherence (NA) was defined as medication possession ratio <80%, calculated during a period in which a patient continued therapy (no treatment gap >90 days) only.ResultsIn the UK sample, 1905 T2DM patients started a treatment with GLP-1 receptor agonists (mean age: 55.5 years, 47.2% female). In the German sample, 1627 T2DM patients started a treatment with GLP-1 receptor agonists (mean age: 56.6 years, 51.4% female). Percentage of NP patients after 12 months was 29.5% in the UK and 36.4% in the German sample. In both countries, a BID treatment was associated with a higher probability to discontinue a treatment with GLP-1 receptor agonists earlier than an OD treatment (hazard ratio [HR] = 1.431 in UK and HR = 1.314 in Germany). The percentages of patients considered NA were 20.2%/20.0%/20.5% (all/OD/BID) for the UK sample, and 19.9%/19.2%/21.8% (all/OD/BID) for the German sample.ConclusionNP and NA to treatment with GLP-1 receptor agonists in both UK and Germany appear to be similar. Persistence to OD treatment is higher than to BID treatment in both the UK and Germany.Electronic supplementary materialThe online version of this article (doi:10.1007/s13300-015-0149-4) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Non-Persistence and Non-Adherence of Patients with Type 2 Diabetes Mellitus in Therapy with GLP-1 Receptor Agonists: A Retrospective Analysis

et al. 2015

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“…Currently, there is limited real-world data regarding adherence to GLP-1RAs for Medicare patients with T2D; however, there is some evidence in commercially insured patients [18, 19]. One 6-month retrospective database study of adult patients with T2D from a large commercial health plan suggested that patients initiating treatment with exenatide QW were more likely to be adherent than patients initiating treatment with exenatide BID and liraglutide QD [20].…”

Section: Introductionmentioning

confidence: 99%

Glucagon-Like Peptide-1 Receptor Agonist (GLP-1RA) Therapy Adherence for Patients with Type 2 Diabetes in a Medicare Population

2017

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IntroductionAnti-diabetes medication regimen adherence is a clinical challenge in elderly patients with type 2 diabetes (T2D) and other comorbidities associated with aging. Glucagon-like peptide-1 receptor agonists (GLP-1RA) therapies such as exenatide once weekly (QW), exenatide twice daily (BID), and liraglutide once daily (QD) are an increasingly used class of drugs with proven efficacy and tolerability. Real-world evidence on adherence to GLP-1RAs in elderly or disabled patients is limited. To further the understanding of this drug class, the current study examined medication adherence in Medicare patients aged ≥65 years with T2D initiating a GLP-1RA.MethodsThis retrospective cohort study used medical and pharmacy claims between 2010 and 2013 for Medicare members in a United States health plan diagnosed with T2D who were new initiators of either exenatide QW (n = 537), exenatide BID (n = 923), or liraglutide QD (n = 3,673). Included patients were between the ages of 65 and 89 and were continuously enrolled for 6 months pre- and post-index. Medication adherence was examined during the post-index period using proportion of days covered (PDC) ≥80% and ≥90%.ResultsA significantly higher percentage of patients receiving exenatide QW had a PDC ≥80% (43.2%) versus exenatide BID (39.0%, P < 0.01) and liraglutide QD (35.0%, P < 0.001). The patients receiving exenatide QW were significantly more likely to reach a PDC of ≥90% (37.2%, P < 0.001) than those initiating exenatide BID (20.6%) or liraglutide QD (23.3%).ConclusionsWhile results from this retrospective study suggest room for improvement in adherence to GLP-1RAs, medication adherence rates for patients initiating therapy with exenatide QW were higher than patients initiating therapy with exenatide BID or liraglutide QD. Further research is needed to validate these findings in other T2D patient populations. Funding: AstraZeneca Pharmaceuticals.

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“…Как отмечалось выше, пациенты в эксперименте с дискретным выбором оце-нивали частоту дозирования как наиболее важный аспект АР ГПП-1, отдавая явное предпочтение препа-ратам с введением 1 р/нед [58]. Менее частое введение также ассоциировано с лучшей приверженностью лече-нию, что продемонстрировано в исследованиях, в ко-торых приверженность терапии АР ГПП-1 длительного действия была выше, чем приверженность терапии АР ГПП-1 короткого действия [59,60].…”

Section: приверженность средства введения и предпочтения пациентаunclassified

Evolution of glucagon-like peptide-1 receptor agonists for the treatment of type 2 diabetes

Galstyan¹,

Karataeva²,

Yudovich³

2017

Diabetes mellitus

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Retrospective Study of Adherence to Glucagon-like Peptide-1 Receptor Agonist Therapy in Patients with Type 2 Diabetes Mellitus in the United States

Abstract: Patients initiating exenatide QW had significantly higher adjusted odds of adherence compared with patients initiating other GLP-1RAs. Given differences in adherence across the GLP-1RAs, research correlating these factors with clinical and economic outcomes is warranted.

Cited by 65 publications

References 28 publications

Non-Persistence and Non-Adherence of Patients with Type 2 Diabetes Mellitus in Therapy with GLP-1 Receptor Agonists: A Retrospective Analysis

Non-Persistence and Non-Adherence of Patients with Type 2 Diabetes Mellitus in Therapy with GLP-1 Receptor Agonists: A Retrospective Analysis

Glucagon-Like Peptide-1 Receptor Agonist (GLP-1RA) Therapy Adherence for Patients with Type 2 Diabetes in a Medicare Population

Evolution of glucagon-like peptide-1 receptor agonists for the treatment of type 2 diabetes

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