Rapid Acting Insulin Use and Persistence among Elderly Type 2 Diabetes Patients Adding RAI to Oral Antidiabetes Drug Regimens

Table 1

Characteristics of elderly (≥65 years) Medicare beneficiaries with type 2 diabetes mellitus who newly added rapid acting insulin to their oral antidiabetic drug regimen. Humana Medicare Advantage Prescription Drug Plan database 2007–2012.

		Column%
All	3,734	100
Number of OADs
1 OAD	1,724	46.2
2 OADs	1,503	40.3
≥3 OADs	507	13.6
Demographic characteristics
Gender
Female	1,899	50.9
Male	1,835	49.1
Race
White	2,971	79.6
African American	516	13.8
Others	157	4.2
Missing	90	2.41
Age in years
65–69 years	1,296	34.7
70–74 years	1,090	29.2
75–79 years	764	20.5
80+ years	584	15.6
Region
Midwest	1,122	30
South	2,227	59.6
Northeast/west/others	385	10.3
Health insurance characteristics
Type of plan
PFFS	1,311	35.1
HMO	1,435	38.4
PPO/others	988	26.5
Baseline clinical characteristics
Any hypoglycemia
Yes	469	12.6
No	3,265	87.4
Severe hypoglycemia
Yes	365	9.8
No	3,369	90.2
aDCSI score
0	926	24.8
1-2	1,141	30.6
3-4	595	15.9
5–13	1,072	28.7
A1C
<7%	377	10.1
7-8%	298	8
8-9%	234	6.3
>9%	332	8.9
Not available	2,493	66.8
Baseline healthcare utilization
Any inpatient visit
Yes	2,460	65.9
No	1,274	34.1
Any ER visit
Yes	2,229	59.7
No	1,505	40.3
Special conditions for the elderly
Polypharmacy
Yes (>14)	537	14.4
No (≤14)	3,197	85.6
Cognitive impairment
Yes	677	18.1
No	3,057	81.9
Depression
Yes	608	16.3
No	3,126	83.7
Fall
Yes	236	6.3
No	3,498	93.7
Urinary incontinence
Yes	173	4.6
No	3,561	95.4
One-year follow-up basal insulin use
Basal insulin
Yes	1,973	52.8
No	1,761	47.2
One-year follow-up RAI out-of-pocket cost per RAI prescription
Average cost per RAI prescription
0.0–<6.3	933	25
6.3–<36	945	25.3
36–<56	923	24.7
≥56	933	25
One-year follow-up RAI out-of-pocket cost per 30-day supply
RAI OOP cost per 30-day supply
0.0–<6.4	934	25
6.4–<35.5	933	25
35.5–<47.6	934	25
≥47.6	933	25

Note: based on 3,734 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.
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.