Persistence to Basal Insulin: Association With Health Outcomes in a Population With Type 2 Diabetes

This study examined the association between persistence to basal insulin and clinical and economic health outcomes. The question of whether a persistence measure for basal insulin could be leveraged in quality measurement was also explored. Using the IBM-Truven MarketScan Commercial and Medicare Supplemental Databases from 1 January 2011 to 31 December 2015, a total of 14,126 subjects were included in the analyses wherein 9,898 (70.1%) were categorized as persistent with basal insulin therapy. Basal insulin persistence was associated with lower A1C, fewer hospitalizations and emergency department visits, and lower health care expenditures. Quality measures based on prescription drug claims for basal insulin are feasible and should be considered for guiding quality improvement efforts.

Key Points

· Persistence to insulin is important to the achievement of glycemic control for people with diabetes.

· Persistence to basal insulin therapy can be readily measured using prescription drug claims data and is related to improved outcomes for people with type 2 diabetes.

· A quality measure for persistence to basal insulin therapy could promote diabetes population health.