Type 2 Diabetes | Treatment Algorithms | Claims Data Analysis | US | 2014

Diabetes is a chronic, progressive metabolic disease in which the body lacks or is resistant to endogenous insulin, leading to a state of persistent high blood sugar (referred to as hyperglycemia). The most common form of the disease is type 2 diabetes, whereby the body becomes resistant to insulin, most often as a result of obesity and sedentary lifestyle. The primary goal of treatment of type 2 diabetes is to achieve and maintain glycemic control and to reduce the risk of both microvascular complications (e.g., diabetic neuropathy, retinopathy, nephropathy) and macrovascular complications (e.g., myocardial infarction, stroke). Because of the progressive nature of type 2 diabetes, the number of antidiabetic medications used tends to increase as the patient progresses. Physicians and treatment guidelines acknowledge the role of metformin as the gold-standard first-line therapy in treating type 2 diabetes. Further therapies (primarily oral agents such as DPP-IV inhibitors, SGLT-2 inhibitors, and sulfonylureas) are typically added as second- and third-line agents to help maintain long-term glycemic control. A significant number of patients progress toward additional therapy with injectable treatments such as the GLP-1 receptor agonists and insulins. Using U.S. patient-level claims data, this report analyzes the use of key therapies in the newly diagnosed and recently treated type 2 diabetes patient populations. With respect to newly diagnosed patients, the report provides a prospective analysis of treatment patterns and share by line of therapy, as well as progression between lines, duration of treatment on each line, and use of concomitant treatment. For recently treated patients, the report quantifies a drug’s source of business compared with its competitors and details which drugs precede others through a retrospective analysis of patient claims data. Additional analyses explore persistency and compliance by brand.