Impact of a Structured Patient-Support Program on Adherence and Persistence with Basal Insulin Therapy at 12 Months

Abstract

The COACH patient-support program was launched in 2015 to support and educate patients prescribed insulin glargine 300 U/mL (Gla-300). The study objective was to assess program impact on adherence and persistence among patients with T2D on Gla-300 therapy. A retrospective cohort study was conducted, linking data from COACH to patient data in the IQVIA Integrated Data Warehouse. Overall inclusion criteria for patients identified from 2/1/2016-7/31/2016 were: ≥1 T2D diagnosis code, aged ≥18 years, ≥1 pharmacy claim for Gla-300 (first claim as index date), continuous database activity for ≥180 days preceding the 6-month pre-index, and pharmacy stability in the 6-month pre-index. Exclusion criteria were: ≥1 pharmacy claim for another basal insulin ≤14 days preceding index, and data-quality issues. Patients from the COACH Participant cohort (active participants of the program) were directly matched to a Non-COACH cohort of patients not enrolled in COACH. Patients who were insulin naive, switched from any other basal insulin to Gla-300, and with high levels of engagement to COACH were analyzed as subcohorts. Treatment persistence and adherence were measured over a 12-month follow-up. The matched cohorts included 544 patients each. Over 12 months, a significantly greater proportion of COACH Participants were persistent (48.5% vs. 42.1%; p=0.0309) and adherent (68.0% vs. 61.4%; p=0.0201) to Gla-300 compared with patients in the Non-COACH cohort. In multivariate adjusted analyses, the odds of being adherent to index medication were 1.81 times higher (OR 1.81; p=0.0002) and the risk of discontinuation was 40% lower (HR 0.60; p<0.0001) for COACH Participants. Similar results were found among naive and switching subcohorts. A higher level of engagement with COACH was associated with a lower risk of discontinuation. Active participation in the COACH patient-support program was associated with improved adherence and persistence to Gla-300. Disclosure F.L. Zhou: Employee; Self; Sanofi. Stock/Shareholder; Self; Sanofi. Employee; Spouse/Partner; Lexicon Pharmaceuticals, Inc.. Stock/Shareholder; Spouse/Partner; Lexicon Pharmaceuticals, Inc. J. Yeaw: Other Relationship; Self; Sanofi US. S. Karkare: None. M. DeKoven: None. T.S. Reid: Speaker's Bureau; Self; Novo Nordisk Inc.. Advisory Panel; Self; Novo Nordisk Inc.. Speaker's Bureau; Self; Sanofi. Advisory Panel; Self; Sanofi, Janssen Pharmaceuticals, Inc.. Speaker's Bureau; Self; Janssen Pharmaceuticals, Inc.. Consultant; Self; AstraZeneca, Intarcia Therapeutics, Inc.. Speaker's Bureau; Self; Lilly.