National Trends in Diabetes Medication Use in the United States: 2008 to 2015

2018 ◽  
Vol 33 (4) ◽  
pp. 433-442 ◽  
Author(s):  
Amit D. Raval ◽  
Ami Vyas
Keyword(s):  
Glucose Transporter ◽  
Medical Expenditure Panel Survey ◽  
Medication Use ◽  
The United States ◽  
Sglt2 Inhibitors ◽  
Medical Expenditure ◽  
Prescription Data ◽  
Diabetes Medication ◽  
Receptor Agonists ◽  
Glucose Transporter 2

Background Data on trends of diabetes medications use are sparse, outdated, and limited to prescription data. We determined trends in diabetes medication use among US individuals with diabetes during 2008-2015. Methods We used 2008-2015 Medical Expenditure Panel Survey to examine diabetes medication utilization among individuals aged ≥18 years with diabetes. Prescription medications were classified based on therapeutic class and subclass using Multum Lexicon database. Results From 2008 to 2015, use of any diabetes medication (81.4% vs. 87%), metformin (47.8% vs. 59.0%), and insulin (23.0% vs. 31.0%) increased, whereas, use of sulfonylurea (36.0% vs. 29.0%) and thiazolidinedione (21% vs. 9.0%) declined. A linear increase was observed in the uptake of dipeptidyl peptidase-4 (DPP-4) inhibitors from 6.2% in 2008 to 12.4% in 2015; glucagon-like peptide-1 (GLP-1) receptor agonists from 2.5% in 2008 to 4.4% in 2015 and sodium glucose transporter-2 (SGLT2) inhibitors from 0.8% in 2014 (the first SGLT2 inhibitors approval year) to 4.4% in 2015. Monotherapy use increased from 50.6% to 56.4% during 2008-2015, while triple therapy use declined. Conclusions Metformin, insulin and sulfonylureas remained the top-three prescribed classes of diabetes medications. Increased use of DPP-4 inhibitors, GLP-1 receptor agonists and SGLT2 inhibitors was offset by decline in TZDs use.

scholarly journals 2163 Polypharmacy and patterns of prescription medication use among cancer survivors

2018 ◽  
Vol 2 (S1) ◽  
pp. 85-86
Author(s):  
Caitlin Murphy ◽  
Hannah Fullington ◽  
Carlos Alvarez ◽  
Simon C. Lee ◽  
Andrea Betts ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Adverse Drug Events ◽  
Medical Expenditure Panel Survey ◽  
Medication Use ◽  
Prescription Medication ◽  
The United States ◽  
Abuse Potential ◽  
Medical Expenditure ◽  
Adolescent And Young Adult ◽  
Increased Risk

OBJECTIVES/SPECIFIC AIMS: The population of cancer survivors is rapidly growing in the United States. Long term and late effects of cancer, combined with ongoing management of other chronic conditions, make cancer survivors particularly vulnerable to polypharmacy and its adverse effects. We examined patterns of prescription medication use and polypharmacy in a population-based sample of cancer survivors. METHODS/STUDY POPULATION: Using data from the Medical Expenditure Panel Survey (MEPS), we matched cancer survivors (n=5216) to noncancer controls (n=19,588) by age, sex, and survey year. We defined polypharmacy as using 5 or more unique medications. We also estimated proportion of respondents prescribed specific medications within therapeutic classes and total prescription expenditures. RESULTS/ANTICIPATED RESULTS: A higher proportion of cancer survivors were prescribed 5 or more unique medications (64.0%, 95% CI 62.3%–65.8%) compared with noncancer controls (51.5%, 95% CI 50.4%–52.6%), including drugs with abuse potential. Across all therapeutic classes, a higher proportion of newly (≤1 year since diagnosis) and previously (>1 years since diagnosis) diagnosed survivors were prescribed medications compared to controls, with large differences in central nervous system agents (65.8% vs. 57.4% vs. 46.2%), psychotherapeutic agents (25.4% vs. 26.8% vs. 18.3%), and gastrointestinal agents (31.9% vs. 29.6% vs. 22.0%). Specifically, nearly 10% of cancer survivors were prescribed benzodiazepines and/or opioids compared to about 5% of controls. Survivors had more than double prescription expenditures (median $1633 vs. $784 among noncancer controls). Findings persisted similarly across categories of age and comorbidity. DISCUSSION/SIGNIFICANCE OF IMPACT: Cancer survivors were frequently prescribed a higher number of unique medications and inappropriate medications or drugs with abuse potential, increasing risk of adverse drug events, financial toxicity, poor adherence, and drug-drug interactions. Adolescent and young adult survivors appear at increased risk of polypharmacy.

scholarly journals The Effect of Massachusetts' Health Reform on Employer-Sponsored Insurance Premiums

2010 ◽  
Vol 13 (2) ◽  
Author(s):  
John F Cogan ◽  
R. Glenn Hubbard ◽  
Daniel Kessler
Keyword(s):  
United States ◽  
Health Reform ◽  
Medical Expenditure Panel Survey ◽  
Private Insurance ◽  
The United States ◽  
Medical Expenditure ◽  
Insurance Premiums ◽  
Reform Plan ◽  
The Difference ◽  
The Cost

In this paper, we use publicly available data from the Medical Expenditure Panel Survey - Insurance Component (MEPS-IC) to investigate the effect of Massachusetts' health reform plan on employer-sponsored insurance premiums. We tabulate premium growth for private-sector employers in Massachusetts and the United States as a whole for 2004 - 2008. We estimate the effect of the plan as the difference in premium growth between Massachusetts and the United States between 2006 and 2008—that is, before versus after the plan—over and above the difference in premium growth for 2004 to 2006. We find that health reform in Massachusetts increased single-coverage employer-sponsored insurance premiums by about 6 percent, or $262. Although our research design has important limitations, it does suggest that policy makers should be concerned about the consequences of health reform for the cost of private insurance.

scholarly journals Are There Racial Disparities in Psychotropic Drug Use and Expenditures in a Nationally Representative Sample of Men in the United States? Evidence From the Medical Expenditure Panel Survey

2013 ◽  
Vol 8 (1) ◽  
pp. 82-90 ◽  
Author(s):  
Geraldine Pierre ◽  
Roland J. Thorpe ◽  
Gniesha Y. Dinwiddie ◽  
Darrell J. Gaskin
Keyword(s):  
United States ◽  
Drug Use ◽  
Racial Disparities ◽  
Psychotropic Drug ◽  
Medical Expenditure Panel Survey ◽  
The United States ◽  
Medical Expenditure ◽  
Panel Survey ◽  
Psychotropic Drug Use ◽  
Nationally Representative

This article sought to determine whether racial disparities exist in psychotropic drug use and expenditures in a nationally representative sample of men in the United States. Data were extracted from the 2000-2009 Medical Expenditure Panel Survey, a longitudinal survey that covers the U.S. civilian noninstitutionalized population. Full-Year Consolidated, Medical Conditions, and Prescribed Medicines data files were merged across 10 years of data. The sample of interest was limited to adult males aged 18 to 64 years, who reported their race as White, Black, Hispanic, or Asian. This study employed a pooled cross-sectional design and a two-part probit generalized linear model for analyses. Minority men reported a lower probability of psychotropic drug use (Black = −4.3%, 95% confidence interval [CI] = [−5.5, −3.0]; Hispanic = −3.8%, 95% CI = [−5.1, −2.6]; Asian = −4.5%, 95% CI = [−6.2, −2.7]) compared with White men. After controlling for demographic, socioeconomic, and health status variables, there were no statistically significant race differences in drug expenditures. Consistent with previous literature, racial and ethnic disparities in the use of psychotropic drugs present problems of access to mental health care and services.

scholarly journals The Ecology of Antihypertensives in the United States, 1997-2017

2020 ◽  
Author(s):  
Michael E. Johansen ◽  
Joshua D. Niforatos ◽  
Jeremey B. Sussman
Keyword(s):  
United States ◽  
Beta Blocker ◽  
Medical Expenditure Panel Survey ◽  
The United States ◽  
Medical Expenditure ◽  
Future Research ◽  
Channel Blockers ◽  
Converting Enzyme Inhibitors ◽  
Cross Sectional ◽  
Medication Class

AbstractBackgroundAntihypertensives are the most used medication type in the United States, yet there remains uncertainty about the use of different antihypertensives. We sought to characterize use of antihypertensives by and within medication class(es) between 1997-2017.MethodsA repeated cross-sectional study of 493,596 adult individuals using the 1997-2017 Medical Expenditure Panel Survey (MEPS). The Orange Book and published research were used for adjunctive information. The primary outcome was the estimated use by and within anti-hypertensive medication class(es).ResultsThe proportion of individuals taking any antihypertensive during a year increased from 1997 to the early 2010’s and then remained stable. The proportion of the population taking 2 or more medications declined from 2015-2017. The proportion of adults using angiotensin II receptor-blockers (ARBs) and dihydropyridine calcium channel-blockers (CCBs) increased during the study period, while angiotensin-converting enzyme inhibitors (ACE-Is) increased until 2010 after which rates remained stable. Beta-blocker use was similar to ACE-Is with an earlier decline starting in 2012. Thiazide diuretic use increased from 1997-2007, leveled off until 2014, and declined from 2015-2017. Non-dihydropyridine CCBs use declined throughout the study. ACE-Is, ARBs, CCBs, thiazide diuretics, and loop diuretics all had one dominant in-class medication. There was a clear increase in the use of losartan within ARBs, lisinopril within ACE-Is, and amlodipine within CCBs following generic conversion. Furosemide and hydrochlorothiazide started with and maintained a dominant position in their classes. Metoprolol use increased throughout the study and became the dominant beta-blocker, while atenolol peaked around 2005 and then declined thereafter.ConclusionsAntihypertensive classes appear to have a propensity to equilibrate to an individual medication, despite a lack of outcomes based research to compare medications within a class. Future research could focus on comparative effectiveness for within-class medications early in the life cycle of therapeutics that are probable to have wide spread use.

scholarly journals Union, Premium Cost, and the Provision of Employment-based Health Insurance

2018 ◽  
Vol 4 ◽  
pp. 237802311879850
Author(s):  
Ken-Hou Lin ◽  
Samuel Bondurant ◽  
Andrew Messamore
Keyword(s):  
Medical Expenditure Panel Survey ◽  
Health Benefits ◽  
State Level ◽  
The United States ◽  
Critical Force ◽  
First Century ◽  
Medical Expenditure ◽  
Health Plans ◽  
Panel Survey ◽  
Employment Relationships

The decline of employment-based health plans is commonly attributed to rising premium costs. Using restricted data and a matched sample from the Medical Expenditure Panel Survey–Insurance Component, the authors extend previous studies by testing the relationships among premium costs, employment relationships, and the provision of health benefits between 1999 and 2012. The authors report that both establishment- and state-level union densities are associated with a higher likelihood of employers’ providing health plans, whereas right-to-work legislation is associated with lower provision. These factors combined rival rising premium cost in predicting offering. This finding indicates that the declining provision of health benefits could be in part driven by the transformation of the employment relationship in the United States and that labor unions may remain a critical force in sustaining employment-based coverage in the twenty-first century.

Sodium-glucose transporter 2 inhibition and cardiovascular events in patients with diabetes: information from clinical trials and observational real-world data

2018 ◽  
Vol 132 (18) ◽  
pp. 2003-2012 ◽  
Author(s):  
Giulia Ferrannini ◽  
Lars Rydén
Keyword(s):  
Real World ◽  
Glucose Transporter ◽  
Sglt2 Inhibitors ◽  
European Medicines Agency ◽  
Real World Data ◽  
Glucose Transporter 2 ◽  
Patients With Diabetes ◽  
Cv Disease ◽  
Intervention Trials ◽  
Randomised Controlled

Cardiovascular (CV) disease (CVD) is the main cause of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM). Despite optimal glycaemic control, standard antihyperglycaemic therapy failed to impact CV events in intervention trials; therefore, the U.S. Food and Drug Administration (FDA) and the European Medicines Agency (EMA) issued a guidance to the pharmaceutical industry to specifically assess the CV outcomes and safety of new glucose-lowering drugs. Amongst them, sodium-glucose transporter 2 (SGLT2) inhibitors proved to not only provide good tolerance, few adverse effects, and good glycometabolic control, but also striking reduction in the risk of CV events. In this review, data from the main randomised controlled trials are presented, including post-hoc analyses looking into several aspects of CV protection. Moreover, the main findings from observational real-world studies to date are described, overall reassuring as regards to CV safety and efficacy of SGLT2 inhibitors. Finally, several mechanisms which might contribute to the cardioprotective effect of SGLT2 inhibition are depicted, including findings from recent mechanistic studies.

scholarly journals Prevalence of and Sociodemographic Disparities in Influenza Vaccination Among Adults With Diabetes in the United States

2020 ◽  
Vol 4 (11) ◽  
Author(s):  
Priyanka Bhugra ◽  
Reed Mszar ◽  
Javier Valero-Elizondo ◽  
Gowtham R Grandhi ◽  
Salim S Virani ◽  
...  
Keyword(s):  
United States ◽  
Influenza Vaccination ◽  
Medical Expenditure Panel Survey ◽  
Vaccine Coverage ◽  
The United States ◽  
Sociodemographic Factors ◽  
Medical Expenditure ◽  
Sociodemographic Characteristics ◽  
Black Race ◽  
Patients With Diabetes

Abstract National estimates describing the overall prevalence of and disparities in influenza vaccination among patients with diabetes mellitus (DM) in United States are not well described. Therefore, we analyzed the prevalence of influenza vaccination among adults with DM, overall and by sociodemographic characteristics, using the Medical Expenditure Panel Survey database from 2008 to 2016. Associations between sociodemographic factors and lack of vaccination were examined using adjusted logistic regression. Among adults with DM, 36% lacked influenza vaccination. Independent predictors of lacking influenza vaccination included age 18 to 39 years (odds ratio [OR] 2.54; 95% confidence interval [CI], 2.14-3.00), Black race/ethnicity (OR 1.29; 95% CI, 1.14-1.46), uninsured status (OR 1.88; 95% CI, 1.59-2.21), and no usual source of care (OR 1.61; 95% CI, 1.39-1.85). Nearly 64% individuals with ≥ 4 higher-risk sociodemographic characteristics lacked influenza vaccination (OR 3.50; 95% CI 2.79-4.39). One-third of adults with DM in the United States lack influenza vaccination, with younger age, Black race, and lower socioeconomic status serving as strong predictors. These findings highlight the continued need for focused public health interventions to increase vaccine coverage and utilization among disadvantaged communities.

The burden of adult asthma in the United States: Evidence from the Medical Expenditure Panel Survey

2011 ◽  
Vol 127 (2) ◽  
pp. 363-369.e3 ◽  
Author(s):  
Patrick W. Sullivan ◽  
Vahram H. Ghushchyan ◽  
Julia F. Slejko ◽  
Vasily Belozeroff ◽  
Denise R. Globe ◽  
...  
Keyword(s):  
United States ◽  
Medical Expenditure Panel Survey ◽  
The United States ◽  
Medical Expenditure ◽  
Panel Survey ◽  
Adult Asthma
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