Dosing of U-100 insulin and associated outcomes among Medicare enrollees with type 1 or type 2 diabetes

Elizabeth L Eby,1 Kate Van Brunt,2 Cynthia Brusko,3 Bradley Curtis,4 Maureen J Lage5 1Global Patient Outcomes and Real World Evidence, Eli Lilly and Co., Indianapolis IN USA; 2Eli Lilly and Co., Windlesham, UK; 3Lilly USA, LLC, Indianapolis, IN, USA; 4Eli Lilly a...

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Autores principales: Eby EL, Van Brunt K, Brusko C, Curtis B, Lage MJ
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Publicado: Dove Medical Press 2015
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spelling oai:doaj.org-article:3b00f7e19d5c4ce8b901e842577cae8b2021-12-02T02:10:00ZDosing of U-100 insulin and associated outcomes among Medicare enrollees with type 1 or type 2 diabetes1178-1998https://doaj.org/article/3b00f7e19d5c4ce8b901e842577cae8b2015-06-01T00:00:00Zhttps://www.dovepress.com/dosing-of-u-100-insulin-and-associated-outcomes-among-medicare-enrolle-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Elizabeth L Eby,1 Kate Van Brunt,2 Cynthia Brusko,3 Bradley Curtis,4 Maureen J Lage5 1Global Patient Outcomes and Real World Evidence, Eli Lilly and Co., Indianapolis IN USA; 2Eli Lilly and Co., Windlesham, UK; 3Lilly USA, LLC, Indianapolis, IN, USA; 4Eli Lilly and Co., Indianapolis, IN, USA; 5HealthMetrics Outcomes Research, LLC, Bonita Springs, FL, USA Objective: To examine costs, resource utilization, adherence, and hypoglycemic events among various doses of U-100 insulin regimens among elderly patients (age ≥65 years) diagnosed with diabetes.Methods: Truven Health Analytics Medicare databases from January 1, 2008 through December 31, 2011 were utilized. General linear models with a gamma distribution and log link were used to examine costs, while logistic and negative binomial regressions were used to examine resource utilization and hypoglycemic events. Analyses controlled for patient characteristics, pre-period comorbidities, general health, and use of antidiabetic medications as well as index dose of insulin.Results: All-cause inpatient, emergency room, and outpatients costs, as well as diabetes-related inpatient costs, were highest among individuals who were treated with an index dose of 10–100 units/day followed by >300 units/day, while drug costs and total costs generally increased as index dosage increased. Resource utilization generally followed the same pattern as costs, with number of office visits increasing as the dose increased and the highest hospital length of stay, number of hospitalizations, number of emergency room visits, and number of diabetes-related hospitalizations were generally highest among those in the lowest and highest index dose cohorts. Compared to patients who initiated with an index dose of 10–100 units/day, all other patients were significantly less likely to achieve an adherence threshold of 80% based upon index dose range, and while those with an index dose of >100–150 units/day were significantly more likely to experience a hypoglycemic event.Conclusion: These results suggest that, for elderly individuals with diabetes, there is a higher patient burden among those who receive the lowest and highest insulin doses. Keywords: insulin, diabetes, costs, resource utilization, adherence, hypoglycemia Eby ELVan Brunt KBrusko CCurtis BLage MJDove Medical Pressarticleinsulindiabetescostsresource utilizationadherencehypoglycemiaGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 10, Pp 991-1001 (2015)
institution DOAJ
collection DOAJ
language EN
topic insulin
diabetes
costs
resource utilization
adherence
hypoglycemia
Geriatrics
RC952-954.6
spellingShingle insulin
diabetes
costs
resource utilization
adherence
hypoglycemia
Geriatrics
RC952-954.6
Eby EL
Van Brunt K
Brusko C
Curtis B
Lage MJ
Dosing of U-100 insulin and associated outcomes among Medicare enrollees with type 1 or type 2 diabetes
description Elizabeth L Eby,1 Kate Van Brunt,2 Cynthia Brusko,3 Bradley Curtis,4 Maureen J Lage5 1Global Patient Outcomes and Real World Evidence, Eli Lilly and Co., Indianapolis IN USA; 2Eli Lilly and Co., Windlesham, UK; 3Lilly USA, LLC, Indianapolis, IN, USA; 4Eli Lilly and Co., Indianapolis, IN, USA; 5HealthMetrics Outcomes Research, LLC, Bonita Springs, FL, USA Objective: To examine costs, resource utilization, adherence, and hypoglycemic events among various doses of U-100 insulin regimens among elderly patients (age ≥65 years) diagnosed with diabetes.Methods: Truven Health Analytics Medicare databases from January 1, 2008 through December 31, 2011 were utilized. General linear models with a gamma distribution and log link were used to examine costs, while logistic and negative binomial regressions were used to examine resource utilization and hypoglycemic events. Analyses controlled for patient characteristics, pre-period comorbidities, general health, and use of antidiabetic medications as well as index dose of insulin.Results: All-cause inpatient, emergency room, and outpatients costs, as well as diabetes-related inpatient costs, were highest among individuals who were treated with an index dose of 10–100 units/day followed by >300 units/day, while drug costs and total costs generally increased as index dosage increased. Resource utilization generally followed the same pattern as costs, with number of office visits increasing as the dose increased and the highest hospital length of stay, number of hospitalizations, number of emergency room visits, and number of diabetes-related hospitalizations were generally highest among those in the lowest and highest index dose cohorts. Compared to patients who initiated with an index dose of 10–100 units/day, all other patients were significantly less likely to achieve an adherence threshold of 80% based upon index dose range, and while those with an index dose of >100–150 units/day were significantly more likely to experience a hypoglycemic event.Conclusion: These results suggest that, for elderly individuals with diabetes, there is a higher patient burden among those who receive the lowest and highest insulin doses. Keywords: insulin, diabetes, costs, resource utilization, adherence, hypoglycemia 
format article
author Eby EL
Van Brunt K
Brusko C
Curtis B
Lage MJ
author_facet Eby EL
Van Brunt K
Brusko C
Curtis B
Lage MJ
author_sort Eby EL
title Dosing of U-100 insulin and associated outcomes among Medicare enrollees with type 1 or type 2 diabetes
title_short Dosing of U-100 insulin and associated outcomes among Medicare enrollees with type 1 or type 2 diabetes
title_full Dosing of U-100 insulin and associated outcomes among Medicare enrollees with type 1 or type 2 diabetes
title_fullStr Dosing of U-100 insulin and associated outcomes among Medicare enrollees with type 1 or type 2 diabetes
title_full_unstemmed Dosing of U-100 insulin and associated outcomes among Medicare enrollees with type 1 or type 2 diabetes
title_sort dosing of u-100 insulin and associated outcomes among medicare enrollees with type 1 or type 2 diabetes
publisher Dove Medical Press
publishDate 2015
url https://doaj.org/article/3b00f7e19d5c4ce8b901e842577cae8b
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