Use of Concurrent Anti-diabetes Medications in Patients With Type 2 Diabetes in Clinical Practice in the United States

Purpose: This report describes the use of combina-tion therapy in patients with type 2 diabetes mellitus (T2DM) who had been initially prescribed metformin in the United States.Methods: Retrospective claims data from a de -identified database were used to identify individuals aged >18 years with >1 claim for a metformin-containing regimen dated between January 1, 2018, and December 31, 2018. Demographics, insurance type, and prescriber type were compared among subgroups receiving two ( dual ) or three or more ( triple + ) anti-diabetes therapies. All analyses were descriptive; no formal comparisons were conducted.Findings: Data from 353,062 patients were in-cluded. Demographic and other baseline characteristics were similar between the groups receiving dual or triple + therapy (n = 213,871 and 139,191, respec-tively). A small age difference was observed between patients receiving dual versus triple + therapy (mean [SD], 66.5 [11.8] and 65.8 [10.8] years, respectively). Mean (SD) glycosylated hemoglobin levels were lower among patients receiving dual therapy versus triple + therapy: 7.6% (1.7) versus 8.0% (1.7). The most frequent combination was metformin plus a sulfony-lurea (33.4%). The percentage receiving combination therapy with newer treatments was relatively low, and slightly greater in younger patients. Total health care costs were similar with dual and triple + therapies.Implications: The current descriptive analysis demonstrated generally similar features, with regard to the evaluated factors, in cohorts receiving dual versus triple + T2DM therapy. However, differences between unmeasured factors could exist and require further evaluation. These findings, based on data from a cohort of patients from clinical practice who had initially been prescribed metformin, provide a useful snapshot of current prescribing practices and can be used to inform future research and evidence-based policy decisions. (Clin Ther. 2022;44:1248-1256.) (c) 2022 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC -ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ )

Automated summary

This study describes the use of combination therapy in patients with type 2 diabetes mellitus in the United States who were initially prescribed metformin, showing similarities in demographics and baseline characteristics between dual and triple + therapy groups, with some differences in age and treatment outcomes.