Utilization of oral hypoglycemic agents in a drug-insured US population

OBJECTIVE - Clinical trials provide information regarding the safety and ef ficacy of medications used to manage type 2 diabetes but do not elucidate d rug effectiveness in a typical managed care environment. The aim of this st udy was to characterize "real-world" drug utilization patterns from both a prescriber and a patient perspective. RESEARCH DESIGN AND METHODS - We conducted a retrospective analysis of a la rge administrative pharmacy claims database, using data on continuously, ph armacy benefit-eligible members prescribed oral hypoglycemic agents (OHAs). RESULTS - The 12-month persistence rate for the OHA cohort was low, ranging from 31% for et-glucosidase inhibitors to 60% for metformin compliance rat es varied between 70 and 80%. During the first 12 months of therapy, 36% of the patients remaining on therapy at 12 months had one or more therapy, mo difications. The mean number of therapy changes increased with the length o f patient follow-up, with more than half of all patients experiencing at le ast one therapy change over the duration of follow-up. CONCLUSIONS - These findings document the wide variation in utilization pat terns associated with pharmacological management Of type 2 diabetes, sugges ting that opportunity exists to optimize its pharmacological management.