title: Predictors of glycemic control and diabetes-related costs among type 2 diabetes patients initiating therapy with liraglutide in the United States.
abstract: OBJECTIVE
  Liraglutide has been shown to significantly improve glycemic control and reduce body weight while minimizing the risk of hypoglycemia in adult patients with type 2 diabetes (T2D). This study aimed to identify characteristics that predict clinical and economic outcomes associated with liraglutide therapy in clinical practice in the US.
  
  
  METHODS
  Using the Truven Health MarketScan Laboratory Database, glycemic control (A1C <7%) and diabetes-related costs were evaluated in T2D patients initiating liraglutide between January 1, 2010 and June 30, 2012. Patients were required to have ≥1 post-index claim for liraglutide and A1C values at baseline and 6 months follow-up. All valid values of baseline A1C were included. Patients previously treated with GLP-1 receptor agonist(s) or insulin, or with evidence of type 1 diabetes, pregnancy, or gestational diabetes during the study period were excluded. Multivariable regression models were used to identify predictors of glycemic control and diabetes-related costs.
  
  
  RESULTS
  Of 417 patients newly treated with liraglutide, 54.0% achieved glycemic control (A1C <7%) during follow-up. Factors associated with increased odds of glycemic control during follow-up were: being female, POS/EPO health plan type, baseline A1C, early liraglutide initiation (0-1 prior oral anti diabetics [OADs] vs ≥2), adherence to liraglutide (defined as the proportion of days covered [PDC]), and diabetic retinopathy. Being female, earlier liraglutide initiation (0-1 prior OADs), and higher patient share of liraglutide costs were associated with significantly lower diabetes-related costs during follow-up. Factors associated with significantly higher post-index diabetes-related costs were: higher baseline A1C, baseline use of sulfonylureas, and diabetic retinopathy.
  
  
  CONCLUSIONS
  Within this commercially-insured population of T2D patients treated with liraglutide, gender, baseline A1C, early liraglutide initiation (0-1 prior OADs), diabetic retinopathy, better adherence, and patient share of liraglutide costs were associated with increased odds of achieving glycemic control and the odds of having higher or lower diabetes-related costs.
authors.affiliation: a a Truven Health Analytics , Bethesda, MD , USA.
authors.forename: Emily
authors.initials: E
authors.lastname: Durden
authors.affiliation: a a Truven Health Analytics , Bethesda, MD , USA.
authors.forename: Greg
authors.initials: G
authors.lastname: Lenhart
authors.affiliation: a a Truven Health Analytics , Bethesda, MD , USA.
authors.forename: Lorena
authors.initials: L
authors.lastname: Lopez-Gonzalez
authors.affiliation: b b Novo Nordisk A/S , Denmark.
authors.forename: Mette
authors.initials: M
authors.lastname: Hammer
authors.affiliation: b b Novo Nordisk A/S , Denmark.
authors.forename: Jakob
authors.initials: J
authors.lastname: Langer
mesh_terms: D001786:Blood Glucose; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000191:economics*; D005260:Female; D006442:Glycated Hemoglobin; D006801:Humans; D007004:Hypoglycemic Agents / Q000191:economics* / Q000627:therapeutic use*; D000069450:Liraglutide / Q000191:economics* / Q000627:therapeutic use*; D008297:Male; D055118:Medication Adherence; D012189:Retrospective Studies; D012737:Sex Factors; D014481:United States
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D000069450:Liraglutide
keywords: Diabetes-related costs; Glycemic control; Liraglutide; Predictors; Type 2 diabetes