title: Increased persistency in medication use by U.S. Medicare beneficiaries with diabetes is associated with lower hospitalization rates and cost savings.
abstract: OBJECTIVE
  To assess the relationship between annual fills for antidiabetes medications, ACE inhibitors, angiotensin II receptor blockers (ARBs), and lipid-lowering agents on hospitalization and Medicare spending for beneficiaries with diabetes.
  
  
  METHODS
  Using Medicare Current Beneficiary Survey data from 1997 to 2004, we identified 7,441 community-dwelling beneficiaries with diabetes, who contributed 14,317 person-years of data for the analysis. We used multivariate regression analysis to estimate the effect of persistency in medication fills on hospitalization risk, hospital days, and Medicare spending.
  
  
  RESULTS
  For users of older oral antidiabetes agents, ACE inhibitors, ARBs, and statins, each additional prescription fill was associated with significantly lower risk of hospitalization, fewer hospital days, and lower Medicare spending.
  
  
  CONCLUSIONS
  These results suggest an economic case for promoting greater persistency in use of drugs with approved indications by Medicare beneficiaries with diabetes; however, additional research is needed to corroborate the study's cross-sectional findings.
authors.affiliation: Peter Lamy Center on Drug Therapy and Aging, University of Maryland Baltimore, Baltimore, Maryland, USA.
authors.forename: Bruce C
authors.initials: BC
authors.lastname: Stuart
authors.forename: Linda
authors.initials: L
authors.lastname: Simoni-Wastila
authors.forename: Lirong
authors.initials: L
authors.lastname: Zhao
authors.forename: Jennifer T
authors.initials: JT
authors.lastname: Lloyd
authors.forename: Jalpa A
authors.initials: JA
authors.lastname: Doshi
mesh_terms: D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000191:economics / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000191:economics / Q000627:therapeutic use; D017046:Cost Savings / Q000191:economics*; D003920:Diabetes Mellitus / Q000188:drug therapy*; D006306:Health Surveys; D006760:Hospitalization / Q000191:economics* / Q000706:statistics & numerical data*; D006801:Humans; D007004:Hypoglycemic Agents / Q000191:economics / Q000627:therapeutic use*; D000960:Hypolipidemic Agents / Q000191:economics / Q000627:therapeutic use; D006278:Medicare; D016012:Poisson Distribution; D012044:Regression Analysis; D014481:United States / Q000453:epidemiology
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D007004:Hypoglycemic Agents; D000960:Hypolipidemic Agents