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Comparisons of rosiglitazone versus pioglitazone monotherapy introduction and associated health care utilization in Medicaid-enrolled patients with type 2 diabetes mellitus.
Clin Ther. 2007 Jun; 29(6 Pt 1):1306-15.CT

Abstract

BACKGROUND

Outcomes in patients with type 2 diabetes mellitus (DM) can differ based on the antidiabetic medication that is used. Thiazolidinediones (TZDs) are a newer class of agents used for the treatment of type 2 DM. No previous study has compared health care utilization associated with the 2 TZDs on the market.

OBJECTIVE

The objective of this study was to compare health care utilization and costs associated with initiation of treatment with either rosiglitazone or pioglitazone by Medicaid-enrolled patients with type 2 DM.

METHODS

This was a retrospective data analysis comparing cohorts of patients with type 2 DM starting a new antidiabetic medication in terms of hospitalizations, emergency department visits, outpatient physician visits, and health care costs reimbursed by the North Carolina Medicaid program. The perspective adopted in this analysis was that of the third-party payer (ie, the North Carolina Medicaid program). Patients starting rosiglitazone between July 1, 2001, and June 30, 2002, were compared with patients starting pioglitazone during the same period. The patients were followed up for 30 months to examine the difference in health care utilization over time. Multivariate regression techniques were employed for comparisons between the 2 different antidiabetic therapies.

RESULTS

A total of 1705 patients with type 2 DM were identified and included in the final cohort. There were 660 patients (mean [SD] age, 49.0 [10.2] years) in the rosiglitazone arm and 1045 patients (mean [SD] age, 49.1 [10.5] years) in the pioglitazone arm. Multivariate analysis showed that the rosiglitazone monotherapy group was associated with a 12.2% decrease in the mean number of hospitalizations, a 10.4% decrease in the mean number of emergency department visits, and a 7.3% decrease in total health care costs compared with the pioglitazone monotherapy group (all, P < 0.05). This study only looked at patients who used the same drug for the entire follow-up period. It did not account for drug switching or addition of a new drug to an existing therapy.

CONCLUSIONS

Introduction of rosiglitazone was associated with a decreased number of hospitalizations, emergency department visits, and total health care costs compared with pioglitazone. The utilization of oral antidiabetic agents, with documented clinical and economic benefits, should continue to be advocated to reduce avoidable medical care utilization and to improve patient outcomes in this population.

Authors+Show Affiliations

Department of Pharmacy Practice and Administration, The Ohio State University, Columbus, Ohio 43210, USA. balkrishnan.l@osu.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18036392

Citation

Balkrishnan, Rajesh, et al. "Comparisons of Rosiglitazone Versus Pioglitazone Monotherapy Introduction and Associated Health Care Utilization in Medicaid-enrolled Patients With Type 2 Diabetes Mellitus." Clinical Therapeutics, vol. 29, no. 6 Pt 1, 2007, pp. 1306-15.
Balkrishnan R, Arondekar BV, Camacho FT, et al. Comparisons of rosiglitazone versus pioglitazone monotherapy introduction and associated health care utilization in Medicaid-enrolled patients with type 2 diabetes mellitus. Clin Ther. 2007;29(6 Pt 1):1306-15.
Balkrishnan, R., Arondekar, B. V., Camacho, F. T., Shenolikar, R. A., Horblyuk, R., & Anderson, R. T. (2007). Comparisons of rosiglitazone versus pioglitazone monotherapy introduction and associated health care utilization in Medicaid-enrolled patients with type 2 diabetes mellitus. Clinical Therapeutics, 29(6 Pt 1), 1306-15.
Balkrishnan R, et al. Comparisons of Rosiglitazone Versus Pioglitazone Monotherapy Introduction and Associated Health Care Utilization in Medicaid-enrolled Patients With Type 2 Diabetes Mellitus. Clin Ther. 2007;29(6 Pt 1):1306-15. PubMed PMID: 18036392.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparisons of rosiglitazone versus pioglitazone monotherapy introduction and associated health care utilization in Medicaid-enrolled patients with type 2 diabetes mellitus. AU - Balkrishnan,Rajesh, AU - Arondekar,Bhakti V, AU - Camacho,Fabian T, AU - Shenolikar,Rahul A, AU - Horblyuk,Ruslan, AU - Anderson,Roger T, PY - 2007/04/23/accepted PY - 2007/11/27/pubmed PY - 2009/9/16/medline PY - 2007/11/27/entrez SP - 1306 EP - 15 JF - Clinical therapeutics JO - Clin Ther VL - 29 IS - 6 Pt 1 N2 - BACKGROUND: Outcomes in patients with type 2 diabetes mellitus (DM) can differ based on the antidiabetic medication that is used. Thiazolidinediones (TZDs) are a newer class of agents used for the treatment of type 2 DM. No previous study has compared health care utilization associated with the 2 TZDs on the market. OBJECTIVE: The objective of this study was to compare health care utilization and costs associated with initiation of treatment with either rosiglitazone or pioglitazone by Medicaid-enrolled patients with type 2 DM. METHODS: This was a retrospective data analysis comparing cohorts of patients with type 2 DM starting a new antidiabetic medication in terms of hospitalizations, emergency department visits, outpatient physician visits, and health care costs reimbursed by the North Carolina Medicaid program. The perspective adopted in this analysis was that of the third-party payer (ie, the North Carolina Medicaid program). Patients starting rosiglitazone between July 1, 2001, and June 30, 2002, were compared with patients starting pioglitazone during the same period. The patients were followed up for 30 months to examine the difference in health care utilization over time. Multivariate regression techniques were employed for comparisons between the 2 different antidiabetic therapies. RESULTS: A total of 1705 patients with type 2 DM were identified and included in the final cohort. There were 660 patients (mean [SD] age, 49.0 [10.2] years) in the rosiglitazone arm and 1045 patients (mean [SD] age, 49.1 [10.5] years) in the pioglitazone arm. Multivariate analysis showed that the rosiglitazone monotherapy group was associated with a 12.2% decrease in the mean number of hospitalizations, a 10.4% decrease in the mean number of emergency department visits, and a 7.3% decrease in total health care costs compared with the pioglitazone monotherapy group (all, P < 0.05). This study only looked at patients who used the same drug for the entire follow-up period. It did not account for drug switching or addition of a new drug to an existing therapy. CONCLUSIONS: Introduction of rosiglitazone was associated with a decreased number of hospitalizations, emergency department visits, and total health care costs compared with pioglitazone. The utilization of oral antidiabetic agents, with documented clinical and economic benefits, should continue to be advocated to reduce avoidable medical care utilization and to improve patient outcomes in this population. SN - 1879-114X UR - https://www.unboundmedicine.com/medline/citation/18036392/Comparisons_of_rosiglitazone_versus_pioglitazone_monotherapy_introduction_and_associated_health_care_utilization_in_Medicaid_enrolled_patients_with_type_2_diabetes_mellitus_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0149-2918(07)00178-6 DB - PRIME DP - Unbound Medicine ER -