Prime Therapeutics' diabetes drug therapy study: Multi-stakeholder improvement needed to help patients stay on, use most clinically appropriate drugs to prevent cardiovascular events

ST. PAUL, Minn., Oct. 24, 2018 /PRNewswire/ -- Pharmacy benefit manager Prime Therapeutics LLC (Prime) recently analyzed both medical and pharmacy claims to identify members with diabetes and the subset with pre-existing cardiovascular disease. The study found that individuals new to diabetes drug therapy are staying on the therapy at substantially lower rates than what the manufacturers report in their published randomized controlled clinical trials; and a substantial portion of members with cardiovascular disease did not take the specific drugs that are clinically shown to provide the best chance of preventing cardiovascular events.

Prime researchers analyzed 15 million commercially insured members to better understand baseline data of members with diabetes regarding persistency and drug selection. Researchers wanted to assess diabetes drug therapy persistency among three drug classes and assess diabetes drug therapy use among individuals with cardiovascular disease to see if drug therapy follows national guidelines.

Approximately 3.6 million members were identified as being continuously enrolled over a four-year period (January 2014-March 2018) with 220,919 individuals having a diabetes diagnosis. Three classes of diabetes drugs were evaluated: DPP-4i, GLP-1 and SGLT-2i. Researchers followed members new to diabetes drug therapy for two years after their first drug class claim. Among the 14,028 DDP-4i, 13,154 GLP-1, and 17,019 SGLT-2i new initiators followed, over 50 percent had discontinued their drug class therapy at 18 months. Clinical trials report persistency of approximately 90 percent at two years.

For individuals with diabetes whose blood sugar is inadequately controlled by lifestyle changes plus metformin drug therapy, the American Diabetes Association (ADA) recommends adding a second class of blood sugar lowering drugs. Based on clinical trials showing improved clinical outcomes with these agents, the ADA now recommends GLP-1 or SGLT-2i as add-on therapy for individuals with established cardiovascular disease. Despite clinical trial data and guideline recommendation of GLP-1 and SGLT-2i therapy, 30 percent of members with diabetes and established ASCVD started on DPP-4i therapy before trying a GLP-1 or SGLT-2i. The percentage using a DPP-4i as first add-on therapy was unchanged from the beginning of 2016 through the first quarter of 2018.

"Our goal is two-fold: We need to not only make sure members are prescribed the most appropriate diabetes medicines according to professional guideline recommendations, but we also need to help them take their medicines as directed," said Patrick Gleason, PharmD, senior director for health outcomes at Prime. "Prime is sharing this real-world data to encourage manufacturers and providers to work with us in implementing programs that will help members better manage their diabetes."

Prime researchers will present this bronze ribbon-winning study at the Academy of Managed Care Pharmacy's (AMCP) Managed Care & Specialty Pharmacy Nexus Meeting Oct. 22-25 in Orlando.

About Prime Therapeutics
Prime Therapeutics LLC (Prime) helps people get the medicine they need to feel better and live well. Prime manages pharmacy benefits for health plans, employers, and government programs including Medicare and Medicaid. The company processes claims and offers clinical services for people with complex medical conditions. Prime serves more than 27 million people. It is collectively owned by 18 Blue Cross and Blue Shield Plans, subsidiaries or affiliates of those plans. For more information, visit www.primetherapeutics.com or follow @Prime_PBM on Twitter.

SOURCE Prime Therapeutics