Retrospective study comparing healthcare costs and utilization between commercially insured patients with type 2 diabetes mellitus who are newly initiating exenatide once weekly or liraglutide in the United States

Abstract

Objective:

To compare healthcare costs and utilization between commercially insured patients with type 2 diabetes mellitus (T2DM) in the United States newly initiating exenatide once weekly (QW) or liraglutide.

Methods:

This retrospective cohort study used US administrative claims data to study patients with T2DM initiating exenatide QW or liraglutide (initiated therapy = index therapy). Patients were included if they had T2DM, were glucagon-like peptide-1 receptor agonist (GLP-1RA) naïve, initiated exenatide QW or liraglutide from 1 February 2012 to 1 October 2012 (date of initiation = index), were ≥18 years at index, and had continuous enrollment for 12 months before (baseline) to 6 months after index (follow-up). Study outcomes were overall and diabetes-specific healthcare utilization and costs. Multivariable regressions compared the study outcomes between exenatide QW and liraglutide, adjusting for potential confounders. Sensitivity analyses were performed to assess liraglutide by dose (1.2 mg/1.8 mg).

Results:

The study sample included 9106 liraglutide (4188, 1.2 mg; 4918, 1.8 mg) patients and 2445 exenatide QW patients. In multivariable-adjusted analyses, compared with liraglutide patients, exenatide QW patients had statistically significantly lower odds of overall inpatient admissions (odds ratio [OR] = 0.80, p = 0.046) and diabetes-specific (OR = 0.83, p = 0.026) inpatient admissions, similar overall total costs ($7833 exenatide QW, $8296 liraglutide, p = 0.069) and diabetes-specific total costs ($3610 exenatide QW, $3736 liraglutide, p = 0.298), and statistically significantly lower overall medical costs ($3939 exenatide QW, $4652 liraglutide, p = 0.008) and diabetes-specific medical costs ($1161 exenatide QW, $1469 liraglutide, p = 0.007). Sensitivity analyses assessing liraglutide by dose were directionally consistent. Unadjusted exploratory analyses showed that exenatide QW patients obtained a greater median number of days supplied for their GLP-1RA during follow-up (141 days) than liraglutide patients (124 days).

Conclusions:

In this 6 month follow-up study, patients receiving exenatide QW had similar total healthcare costs but lower odds of inpatient admission and lower medical costs compared with patients receiving liraglutide.

Keywords::

• Glucagon-like peptide-1 receptor agonist
• Healthcare costs
• Type 2 diabetes mellitus

Transparency

Declaration of funding

This study was sponsored by AstraZeneca, Fort Washington, PA, USA and Bristol-Myers Squibb, Plainsboro, NJ, USA.

Declaration of financial/other relationships

S.S.J., K.C., J.K.N., and B.-C.C. have disclosed that they are employees of Truven Health Analytics, which was paid by the study sponsors to conduct this study. H.N. and I.K. have disclosed that they are employees of AstraZeneca and were employees of Bristol-Myers Squibb at the time this study was conducted. All named authors meet the ICMJE criteria for authorship for this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval to the version to be published.

JME peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgments

Boris Ivanov, employee of Truven Health Analytics, provided statistical programming support for this study. Eugene Felber, an employee of Bristol-Myers Squibb, contributed to the study design.

Notes

*MarketScan is a registered trade name of Truven Health, Ann Arbor, MI, USA