Real-world evidence concerning clinical and economic outcomes of switching to insulin glargine 300 units/mL vs other basal insulins in patients with type 2 diabetes using basal insulin

Diabetes Obes Metab. 2018 May;20(5):1293-1297. doi: 10.1111/dom.13199. Epub 2018 Jan 24.

Abstract

This retrospective cohort study compared real-world clinical and healthcare-resource utilization (HCRU) data in patients with type 2 diabetes using basal insulin (BI) who switched to insulin glargine 300 units/mL (Gla-300) or another BI. Data from the Predictive Health Intelligence Environment database 12 months before (baseline) and 6 months after (follow-up) the switch date (index date, March 1, 2015 to May 31, 2016) included glycated haemoglobin A1c (HbA1c), hypoglycaemia, HCRU and associated costs. Baseline characteristics were balanced using propensity score matching. Change in HbA1c from baseline was similar in both matched cohorts (n = 1819 in each). Hypoglycaemia incidence and adjusted event rate were significantly lower with Gla-300. Patients switching to Gla-300 had a significantly lower incidence of HCRU related to hypoglycaemia. All-cause and diabetes-related hospitalization and emergency-department HCRU were also favourable for Gla-300. Lower HCRU translated to lower costs in patients using Gla-300. In this real-world study, switching to Gla-300 reduced the risk of hypoglycaemia in patients with type 2 diabetes when compared with those switching to another BI, resulting in less HCRU and potential savings of associated costs.

Keywords: basal insulin; glycaemic control; hypoglycaemia; observational study; type 2 diabetes.

Publication types

  • Comparative Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cohort Studies
  • Cost Savings*
  • Costs and Cost Analysis
  • Delivery of Health Care, Integrated
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / economics
  • Drug Compounding
  • Drug Monitoring / economics
  • Electronic Health Records
  • Female
  • Follow-Up Studies
  • Glycated Hemoglobin / analysis
  • Health Care Costs*
  • Humans
  • Hyperglycemia / economics
  • Hyperglycemia / prevention & control*
  • Hyperglycemia / therapy
  • Hypoglycemia / chemically induced
  • Hypoglycemia / economics
  • Hypoglycemia / prevention & control*
  • Hypoglycemia / therapy
  • Insulin / adverse effects
  • Insulin / economics
  • Insulin / therapeutic use
  • Insulin Glargine / adverse effects
  • Insulin Glargine / economics
  • Insulin Glargine / therapeutic use*
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care
  • Retrospective Studies
  • United States

Substances

  • Glycated Hemoglobin A
  • Insulin
  • hemoglobin A1c protein, human
  • Insulin Glargine