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. 2009 Apr;32(4):647-9.
doi: 10.2337/dc08-1311. Epub 2009 Jan 26.

Increased persistency in medication use by U.S. Medicare beneficiaries with diabetes is associated with lower hospitalization rates and cost savings

Bruce C Stuart  1 , Linda Simoni-Wastila, Lirong Zhao, Jennifer T Lloyd, Jalpa A Doshi
Affiliations

Increased persistency in medication use by U.S. Medicare beneficiaries with diabetes is associated with lower hospitalization rates and cost savings

Bruce C Stuart et al. Diabetes Care. 2009 Apr.

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.

Research design and 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.

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References

    1. Stuart B, Simoni-Wastila L, Zuckerman I, Doshi J, Shea D, Shaffer T, Zhao L: Chartbook of Medication Use by Aged and Disabled Medicare Beneficiaries across the Spectrum of Morbidity. Baltimore, MD, the Peter Lamy Center on Drug Therapy and Aging, 2007
    1. American Diabetes Association: Economic costs of diabetes in the U.S. in 2007. Diabetes Care 31: 596– 615, 2008 - PubMed
    1. American Diabetes Association: Economic costs of diabetes in the U.S. in 2002. Diabetes Care 26: 917– 932, 2003 - PubMed
    1. Shenolikar RA, Balkrishnan R: Oral antidiabetes medication adherence and health care utilization among Medicaid-enrolled type 2 diabetic patients beginning monotherapy. Diabetes Care 2: e5, 2008 - PubMed
    1. Sokol MC, McGuigan KA, Verbrugge RR, Epstein RS: Impact of medication adherence on hospitalization risk and healthcare cost. Med Care 43: 521– 530, 2005 - PubMed

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