ArticleThe Annals of pharmacotherapy2015
Regional variation in use of a new class of antidiabetic medication among medicare beneficiaries: the case of incretin mimetics.
Article in The Annals of pharmacotherapy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Disparities in GLP-1RA and SGLT2i Uptake: a Systematic Review and an Equity-First Framework for Cardiovascular-Kidney-Metabolic Care.Current cardiology reports · 2026Pooled it
- First-Line Therapy for Type 2 Diabetes With Sodium-Glucose Cotransporter-2 Inhibitors and Glucagon-Like Peptide-1 Receptor Agonists : A Cost-Effectiveness Study.Annals of internal medicine · 2022Article
- Association between physician adoption of a new oral anti-diabetic medication and Medicare and Medicaid drug spending.BMC health services research · 2019Article
- Penetration of new antidiabetic medications in East Asian countries and the United States: A cross-national comparative study.PloS one · 2018Observational
- Metformin Safety Warnings and Diabetes Drug Prescribing Patterns for Older Nursing Home Residents.Journal of the American Medical Directors Association · 2017Article
- Patient-Centered Guidelines for Geriatric Diabetes Care: Potential Missed Opportunities to Avoid Harm.Journal of the American Board of Family Medicine : JABFMArticle
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundWhen incretin mimetic (IM) medications were introduced in 2005, their effectiveness compared with other less-expensive second-line diabetes therapies was unknown, especially for older adults. Physicians likely had some uncertainty about the role of IMs in the diabetes treatment armamentarium. Regional variation in uptake of IMs may be a marker of such uncertainty.
objectiveTo investigate the extent of regional variation in the use of IMs among beneficiaries and estimate the cost implications for Medicare.
methodsThis was a cross-sectional analysis of 2009-2010 claims data from a nationally representative sample of 238 499 Medicare Part D beneficiaries aged ≥65 years, who were continuously enrolled in fee-for-service Medicare and Part D and filled ≥1 antidiabetic prescription. Beneficiaries were assigned to 1 of 306 hospital-referral regions (HRRs) using ZIP codes. The main outcome was adjusted proportion of antidiabetic users in an HRR receiving an IM.
resultsOverall, 29 933 beneficiaries (12.6%) filled an IM prescription, including 26 939 (11.3%) for sitagliptin or saxagliptin and 3718 (1.6%) for exenatide or liraglutide. The adjusted proportion of beneficiaries using IMs varied more than 3-fold across HRRs, from 5th and 95th percentiles of 5.2% to 17.0%. Compared with non-IM users, IM users faced a 155% higher annual Part D plan ($1067 vs $418) and 144% higher patient ($369 vs $151) costs for antidiabetic prescriptions.
conclusionAmong older Part D beneficiaries using antidiabetic drugs, substantial regional variation exists in the use of IMs, not accounted for by sociodemographics and health status. IM use was associated with substantially greater costs for Part D plans and beneficiaries.
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