This study explored the treatment pattern of newly diagnosed type 2 diabetes (T2D) patients in 2015 using the Commercial and Medicare MarketScan databases. Therapy lines were defined in Table 1. A total of 115,091 adult patients with newly diagnosed (Dx) T2D were identified. Of patients who had antidiabetic drug (ADD) claims within a year after first T2D Dx (n = 53,041), about 20% progressed to second line. The average time from initial Dx to first line and from first to second line were 53 and 117 days respectively. The proportion of combination therapy (≥ 2 ADDs) was increased from 12% in first line to 63% in second line. Table 1 captured the top 20 therapies in each line. About 76% of patients started with metformin (MET) as monotherapy or in combination with sulfonylurea (SU). Substantial variation exists in second line therapies with SU leading the top monotherapy (8.7%). A very small number of patients received newer drugs such as dapagliflozin, dulaglutide and empagliflozin. In line with ADA recommendations, the majority of patients initiated MET-based regimens in first line. SUs were widely used in second line. Despite ongoing research and drug development, little has changed in prescribing of ADD, suggesting a need for better understanding of the gaps in diabetes management and/or education on use and benefits of newer drugs. This study most likely underestimated ADD therapy due to lack of prescriptions filled without pharmacy benefits.
J. Wu: None. J. Xie: None. S. Wong-Jacobosn: None. V.S. Haynes: Employee; Self; Eli Lilly and Company. Stock/Shareholder; Self; Eli Lilly and Company. Z. Zhao: None.
