Non-Adherence And Non-Persistence Related To Glp-1 Therapy In Patients With Diabetes Mellitus Type 2 (T2dm): Analysis of A Large German Claims-Based Dataset And Comparison To Oral Anti-Diabetics

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Non-Adherence And Non-Persistence Related To Glp-1 Therapy In Patients With Diabetes Mellitus Type 2 (T2dm): Analysis of A Large German Claims-Based Dataset And Comparison To Oral Anti-Diabetics
Autor Thomas Wilke, Groth A, Berg B, Sikirica M, Martin AA, Fuchs A, Maywald U.
In: Value in Health
Ausgabe 17(7)
ISBN/ISSN:
Erscheinungsjahr 2014
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OBJECTIVES

This study describes the extent of non-adherence (NA) and non-persistence (NP) with Glucagon-like peptide 1 agonists (GLP-1) and oral anti-diabetic (OAD) therapy in T2DM patients in clinical practice in Germany.

METHODS

Claims data from a German sickness fund (AOK Plus) from 2010-2012 were used to identify patients with ≥ 1 diagnosis for T2DM. NA/NP were measured for patients initiating new T2DM medication (no prescription of respective medication in prior 6 months ) over a minimum of 12 months. A 100% adherence to therapy was assumed equivalent to the drug-specific DDD (defined daily dosage). NP was defined as a medication gap ≥ 90 days. Adherence was calculated via medication possession ratios (MPR), NA was defined as MPR[lt]80%. Descriptive analyses with percentage of patients affected by NP and/or NA were conducted.

RESULTS

The NP analysis, included 2,490/42,891 T2DM patients initiating GLP-1s/OADs. Among GLP-1 patients, 408/1,727/135 received twice-daily (BID; exenatide)/once-daily (OD; liraglutide)/once-weekly (OW; exenatide) therapies. Average age for GLP-1/OAD users was 56 (SD 10.8)/67 (SD 12.6) years. After 12 months, the percentage of patients with NP was 36.83% (all GLP-1s), 42.65% (BID), 37.64% (OD), 27.41% (OW), and 55.87% (OAD). The NA analysis included 2,154/34,128 T2DM patients initiating GLP-1/OAD therapy with ≥1 follow-up prescription. Average age was 56 (SD 10.6)/66 (SD 12.2) years. Average MPR was 88.2% (all GLP-1s), 87.8% (BID), 88.2% (OD), 95.0% (OW), and 63.2% (OAD). Percentage of patients affected by NA was 21.96% (all GLP-1s), 23.98% (BID), 22.00% (OD), 5.74% (OW), and 65.82% (OAD).

CONCLUSIONS

In this German dataset, overall patients with T2DM had low rates of adherence and persistence despite the chronic nature of the disease and clinical sequelae. Higher adherence and persistence rates were observed with GLP-1s than with OAD medications and also with less frequently dosed GLP-1s.