Diabetes drug compliance and blood sugar control: Geographic variation shows need for targeted strategies

Date Posted : December 22, 2015


Eleonora Tan, MSc, PhD; Wenya Yang, MPA, MA; Bo Pang, MS; Mingliang Dai, MS; F. Ellen Loh, BSPharm, MBA; and Paul Hogan, CPhil. Geographic Variation in Antidiabetic Agent Adherence and Glycemic Control Among Patients with Type 2 Diabetes. J Manag Care Spec Pharm, 2015 Dec;21(12):1195-1202.

A Lewin study published in the December 2015 issue of the Journal of Managed Care & Specialty Pharmacy has identified variations in diabetes drug adherence or blood sugar control across the country and pinpointed states and metro areas that could benefit from heightened adherence strategies. The study was funded by Novo Nordisk Inc.

The study focused on insured individuals with type 2 diabetes, who had insurance coverage and received diabetes medication. The researchers used a 2012 administrative claims database from a large commercial health plan, the complete 2011 Medicare Standard Analytical File linked with Part D claims, and the 2008 Mini-Medicaid Analytic eXtract (Mini-Max). Previous studies had examined medication compliance and diabetes control at a national scale. This was the first to drill down to the state and local level.

Key findings include:

  • Adherence to oral and injectable medications varied significantly across states, metropolitan statistical areas (MSAs) and types of insurance. The Medicare population had the highest adherence, while the commercial population had the highest level of diabetes control — partially because of younger age and shorter disease duration.
  • States in the Northeast and Midwest were identified as doing better than average in drug adherence and diabetes control, while southern states were found to have larger gaps in these measures.

The study emphasizes the need to educate patients on why they need to take their medication, even when they have no symptoms, and how noncompliance can jeopardize their health.

The full text of the article is available for free on the JMCP website.

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Client Area: Federal Government
Expertise Area: Chronic Disease / Cost of Illness, Medicaid and CHIP, medicare