Visual Abstract
Aims: Karter et al. validated a hypoglycemia risk stratification tool using electronic medical records that classifies 12-month risk of hypoglycemia-related utilization (HRU; i.e. emergency department/inpatient hospital). For population decision makers, we adapted and applied the tool using a US claims database and tested its performance. We looked at glucagon prescription fills across risk strata as a potential targeted intervention.
Methods: The adapted algorithm was applied to the IBM MarketScan® Research database (index: Jan 1, 2019) to stratify adults with T1D or T2D into 3 risk groups. Discrimination of risk groups was evaluated by measuring HRU 12 months post-stratification.
Results: Among T2D, 31,628 (4.8%) and 5576 (0.8%) were categorized into intermediate and high risk groups, respectively (Table 1; T1D: 3486 [8.5%] and 3768 [9.1%]). Higher HRU were observed in the intermediate (T2D: 1.9%; T1D: 3.2%) and high (T2D: 5.2%; T1D: 8.6%) risk groups compared to low risk (T2D: 0.2%; T1D:1.2%). Glucagon prescriptions were filled by 3.1% of the T2D high risk group.
Conclusions: Using claims data, this risk stratification tool discriminated the 12-month occurrence of HRU between risk groups, which may help facilitate targeted population management interventions. Low glucagon prescription fills suggest a potential population management intervention for people at higher risk for hypoglycemia.
E. R. Hankosky: Employee; Self; Eli Lilly and Company, Stock/Shareholder; Self; Eli Lilly and Company. C. R. Vallarino: Employee; Self; Eli Lilly and Company. B. Falcon: Employee; Self; Eli Lilly and Company, Employee; Spouse/Partner; Elanco. S. Wong-jacobosn: None. B. B. Bentz: Employee; Self; Eli Lilly and Company. B. Mitchell: Employee; Self; Eli Lilly and Company, Stock/Shareholder; Self; Eli Lilly and Company, Stock/Shareholder; Spouse/Partner; Eli Lilly and Company.
Eli Lilly and Company
