CVS Health Study: Newly diagnosed diabetes patients benefit when started on generic Rx

WOONSOCKET, R.I. — Diabetes treatment with a low-cost generic drug can have significant, positive implications for a patient's quality of life and medication cost, according to new research from CVS Health.



The research, conducted by researchers at the CVS Health Research Institute and Brigham and Women's Hospital, and was published this week in JAMA Internal Medicine, found that starting a new diabetes patient on metformin, a generic oral diabetes medicine that helps control blood sugar levels, reduced the need to add on additional treatments to control the condition over time.



Although there are many classes of oral diabetes medications, there has historically been little evidence available on the comparative effectiveness of treatments to help patients and providers select an initial diabetes therapy.



"With more than 25 million Americans affected and annual costs totaling more than $174 billion, diabetes remains a national public health priority," stated Niteesh Choudhry, associate physician, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, associate professor, Harvard Medical School and an author of the study. "By focusing our research on treatment intensification, which can be very difficult for patients and is inherently associated with increased side effects and costs, this study provides useful information to help patients and their doctors select an initial therapy."



Researchers used medical and prescription insurance claims data to look at more than 15,000 patients who were prescribed an oral glucose-lowering medication between July 1, 2009 and June 30, 2013. The study found that patients who started treatment with a sulfonylurea (SFU), a dipeptidyl peptidase-4 (DPP-4) inhibitor, and a thiazolidinedione (TZD) were significantly more likely to add an oral agent, a second oral agent, or insulin than patients who started on metformin. 



"It is essential to identify the simplest therapy for patients to assure they stay on their medication," stated William Shrank, chief scientific officer at CVS Health.  "Research indicates that when patients and providers need to intensify treatment with a second drug or insulin to achieve the desired health outcome, it can reduce patient quality of life in the same way that complications related to the disease can."

 

According to researchers, this research supports the clinical evidence that metformin should be selected as first-line diabetes treatment; however, it also indicates the ongoing need for information to support the benefits of following diabetes treatment guidelines. The study found that while 58% of patients started on metformin — consistent with guideline recommendations — a variety of other therapies were used for the remaining 42% of patients, which can impact both patient outcomes and health care cost. Other research from CVS Caremark, published in the American Journal of Medicine in 2012, had found that physicians in 35% of newly diagnosed diabetes cases did not follow the recommended treatment guidelines. That 2012 research suggested that failure to follow treatment guidelines could result in quality of care implications and cost the health care system up to $420 million annually in additional costs. 



The Research Institute has been supporting a multi-year research collaboration with Brigham and Women's Hospital to better understand patient behavior, particularly around medication adherence.