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. 2016 Sep 28;2016:5374931. doi: 10.1155/2016/5374931

Table 4.

Description of elderly (≥65 years) Medicare beneficiaries with type 2 diabetes mellitus who newly added rapid acting insulin to their oral antidiabetic drug regimen by rapid acting insulin persistence during one-year follow-up. Humana Medicare Advantage Prescription Drug Plan database 2007–2012 (row%).

  Persistence Measure 1 Persistence Measure 2
  Persistent Nonpersistent P value Persistent Nonpersistent P value
N Row% N Row% N Row% N Row%
All (N = 2,334) 429 18.4 1,905 81.6   787 33.7 1,547 66.3  
Number of OADs         <0.001         <0.01
 1 OAD 155 15.4 849 84.6   307 30.6 697 69.4  
 2 OADs 187 19.1 790 80.9   336 34.4 641 65.6  
 ≥3 OADs 87 24.6 266 75.4   144 40.8 209 59.2  
Demographic characteristics
Gender                   <0.05
 Female 228 18.9 978 81.1   432 35.8 774 64.2  
 Male 201 17.8 927 82.2   355 31.5 773 68.5  
Race                    
 White 337 18.2 1,517 81.8   626 33.8 1,228 66.2  
 African American 57 18.2 256 81.8   107 34.2 206 65.8  
 Others 35 21.0 132 79.0   54 32.3 113 67.7  
 Missing                    
Age in years                    
 65–69 years 337 18.2 1,517 81.8   626 33.8 1,228 66.2  
 70–74 years 57 18.2 256 81.8   107 34.2 206 65.8  
 75–79 years 21 20.8 80 79.2   30 29.7 71 70.3  
 80+ years 14 21.2 52 78.8   24 36.4 42 63.6  
Region                   <0.001
 Midwest 160 20.8 608 79.2   294 38.3 474 61.7  
 South 221 16.9 1,086 83.1   396 30.3 911 69.7  
 Northeast/west/others 48 18.5 211 81.5   97 37.5 162 62.5  
Health insurance characteristics
Type of plan                    
 PFFS 171 20.6 661 79.4   302 36.3 530 63.7  
 HMO 143 16.4 728 83.6   275 31.6 596 68.4  
 PPO/others 115 18.2 516 81.8   210 33.3 421 66.7  
Baseline clinical characteristics
Any hypoglycemia                    
 Yes 50 18.7 218 81.3   92 34.3 176 65.7  
 No 379 18.3 1,687 81.7   695 33.6 1,371 66.4  
Severe hypoglycemia                    
 Yes 41 19.9 165 80.1   70 34.0 136 66.0  
 No 388 18.2 1,740 81.8   717 33.7 1,411 66.3  
aDCSI score                    
 0 105 17.5 495 82.5   198 33.0 402 67.0  
 1-2 143 19.9 574 80.1   256 35.7 461 64.3  
 3-4 58 16.4 296 83.6   119 33.6 235 66.4  
 5–13 123 18.6 540 81.4   214 32.3 449 67.7  
A1C                    
 <8% 62 16.7 310 83.3   120 32.3 252 67.7  
 8-9% 23 14.1 140 85.9   47 28.8 116 71.2  
 >9% 43 17.2 207 82.8   86 34.4 164 65.6  
 Not available 301 19.4 1,248 80.6   534 34.5 1,015 65.5  
Baseline healthcare utilization
Any inpatient visit         <0.05          
 Yes 282 19.7 1,146 80.3   488 34.2 940 65.8  
 No 147 16.2 759 83.8   299 33.0 607 67.0  
Any ER visit         <0.05          
 Yes 263 20.0 1,055 80.0   456 34.6 862 65.4  
 No 166 16.3 850 83.7   331 32.6 685 67.4
Special conditions for the elderly
Polypharmacy                    
 Yes (>14) 50 16.2 259 83.8   90 29.1 219 70.9  
 No (≤14) 379 18.7 1,646 81.3   697 34.4 1,328 65.6  
Cognitive impairment         <0.001         <0.001
 Yes 116 25.6 337 74.4   195 43.0 258 57.0  
 No 313 16.6 1,568 83.4   592 31.5 1,289 68.5  
Depression                    
 Yes 86 21.7 311 78.3   139 35.0 258 65.0  
 No 343 17.7 1,594 82.3   648 33.5 1,289 66.5  
Fall                   <0.05
 Yes 34 24.3 106 75.7   60 42.9 80 57.1  
 No 395 18.0 1,799 82.0   727 33.1 1,467 66.9  
Urinary incontinence                    
 Yes 26 23.6 84 76.4   42 38.2 68 61.8  
 No 403 18.1 1,821 81.9   745 33.5 1,479 66.5  
One-year follow-up basal insulin use
Basal insulin         <0.05         <0.01
 Yes 280 19.7 1,140 80.3   510 35.9 910 64.1  
 No 149 16.3 765 83.7   277 30.3 637 69.7  
One-year follow-up RAI out-of-pocket cost per RAI prescription
Average OOP cost         <0.001         <0.001
 $0.0–<$6.3 112 22.0 398 78.0   180 35.3 330 64.7  
 $6.3–<$36 38 16.0 200 84.0   85 35.7 153 64.3  
 $36–<$56 62 8.9 636 91.1   106 15.2 592 84.8  
 ≥$56 217 24.4 671 75.6   416 46.8 472 53.2  
One-year follow-up out-of-pocket RAI cost per 30-day supply
OOP cost per 30-day supply         <0.001         <0.001
 $0.0–<$6.4 171 26.3 480 73.7   281 43.2 370 56.8  
 $6.4–<$35.5 71 13.5 453 86.5   145 27.7 379 72.3  
 $35.5–<$47.6 49 9.2 482 90.8   115 21.7 416 78.3  
 ≥$47.6 138 22.0 490 78.0   246 39.2 382 60.8  

Note: based on 2,334 elderly Medicare beneficiaries aged 65 years and above with type 2 diabetes mellitus, who were continuously enrolled in the Humana Medicare prescription drug plans for 18 months between 2007 and 2011 and added rapid acting insulin to their oral antidiabetic drugs regimen. These individuals had at least 2 claims for rapid acting insulin during the follow-up period. Significant group differences in persistence were tested with chi-square tests.

A1C: glycated hemoglobin; aDCSI: adapted-Diabetes Complications Severity Index; ER: emergency room; HMO: health maintenance organization; OAD: oral antidiabetic drug; PFFS: private fee-for-service; PPO: preferred provider organization; RAI: rapid acting insulin.