School of Pharmacy
Pharmaceutical Systems and Policy
We examined the real-world utilization and persistence of rapid acting insulin (RAI) in elderly patients with type 2 diabetes who added RAI to their drug (OAD) regimen. Insulin-na¨ıve patients aged ≥65 years, with ≥1 OAD prescription during the baseline period, who were continuously enrolled in the US Humana Medicare Advantage insurance plan for 18 months and initiated RAI were included. Among patients with ≥2 RAI prescriptions (RAIp), persistence during the 12-month follow-up was assessed. Multivariate logistic regression analyses identified factors affecting RAI use and persistence. Of 3734 patients adding RAI to their OAD regimen, 2334 (62.5%) had a RAIp during follow-up. Factors associated with RAIp included using ≤2 OADs; cognitive impairment, basal insulin use during follow-up; and higher RAI out-of-pocket costs ($36 to <$56 versus $0 to $6.30). Patients were less likely to persist with RAI when on ≤2 OADs versus ≥3 OADs and when having higher RAI out-of-pocket costs ($36 to <$56 versus $0 to $6.30) and more likely to persist when they had cognitive impairment and basal insulin use during follow-up. Real-world persistence of RAI in insulin-na¨ıve elderly patients with type 2 diabetes was very poor when RAI was added to an OAD regimen.
Digital Commons Citation
Sambamoorthi, Usha; Deb, Arijita; Zhou, Steve; Garg, Rahul; Fan, Tao; and Boss, Anders, "Rapid Acting Insulin Use and Persistence among Elderly Type 2 Diabetes Patients Adding RAI to Oral Antidiabetes Drug Regimens" (2016). Faculty & Staff Scholarship. 2370.
Sambamoorthi, U., Deb, A., Zhou, S., Garg, R., Fan, T., & Boss, A. (2016). Rapid Acting Insulin Use and Persistence among Elderly Type 2 Diabetes Patients Adding RAI to Oral Antidiabetes Drug Regimens. Journal of Diabetes Research, 2016, 1–12. https://doi.org/10.1155/2016/5374931