Treatment Algorithms

December 2012

Key Findings from Treatment Algorithms: Type 2 Diabetes 2012


The Treatment Algorithms Insight Series delivers real value by examining physicians’ actual prescribing behavior as they initiate therapy and move through second- and third-line choices. Our analysis is supported by a deep longitudinal patient-level claims dataset, and provides a representative sample of U.S. treatment practice for Medicare supplemental and commercially insured patients. The claims are less than 6 months old at the time of publication.

This report is updated quarterly and is delivered in three parts:

- Key Findings PowerPoint Deck: includes expert insight and analysis of quarterly trends.

- Treatment Algorithms Dashboard: online interactive platform allows users to quickly maneuver to and view their data of interest.

- Excel Data File: includes underlying data for key graphs and tables.


Patient Sample:

- Patients age 18 or older who are continuously enrolled for the complete two-year study period must meet one of the following conditions:

* At least one prescription from the drug list and at least one claim with a diagnosis code for Type 2 Diabetes (International Classification of Diseases, Ninth Revision [ICD-9] diagnostic codes 250.00, 250.02, 250.10, 250.12, 250.20, 250.22, 250.30, 250.32, 250.40, 250.42, 250.50, 250.52, 250.60, 250.62, 250.70, 250.72, 250.80, 250.82, 250.90, 250.92) during the study period. OR

* At least two claims with any of the above diagnosis codes for Type 2 Diabetes in the two-year period (both claims must be at least 30 days apart) OR

* At least one claim with any of the above diagnosis codes for Type 2 Diabetes in the two-year period and at least two laboratory codes for an HbA1c test (CPT 83036) in the second year of the study period only OR

* At least one prescription for an oral antidiabetic agent and one prescription for either insulin or Symlin

* Patients between the ages of 18 and 40 who receive a prescription for either insulin or Symlin but do not receive an oral antidiabetic agent are excluded from the Type 2 Diabetes analysis as these patients are highly likely to have Type 1 Diabetes. Although Type 1 Diabetes patients older than the age of 40 could potentially be captured in our analysis, we strongly believe that the vast majority of sampled patients are accurately diagnosed with Type 2 Diabetes.

Newly Diagnosed Patients:

- Patient share by drug class and key products across three lines of therapy, within one year of diagnosis

- Patient flow chart through one year of treatment for all first-line products, including progression rates and add/switch behavior

- Polypharmacy and key concomitant therapies by line of therapy

- Quarterly trending of patient share by line of therapy

Recently Treated Patients:

- Quarterly snapshot of patient share by drug class and key products

- Pathway to key therapy flowcharts tracking the preceding therapy patterns for all key therapies, including add/switch behavior

- Brand source of business including share for continuing, new (switches/adds), new (initial therapy) business

- Polypharmacy and key concomitant therapies

- Drug persistence

- Quarterly trending of patient share for all key therapies.

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Mentioned in this report:

  • Products Included in This Analysis:
  • - Alpha-glucosidase inhibitors
  • - Actoplus MET
  • - Actos
  • - Apidra
  • - Avandamet
  • - Avandaryl
  • - Bydureon
  • - Byetta
  • - Duetact
  • - Glipizide-metformin
  • - Glyburide-metformin
  • - Humalog
  • - Intermediate-acting regular insulin (NPH insulin)
  • - Janumet
  • - Januvia
  • - Jentadueto
  • - Juvisync
  • - Kombiglyze XR
  • - Lantus
  • - Levemir
  • - Long-acting regular insulin
  • - Meglitinides
  • - Metformin
  • - Mixed Insulin
  • - Novolog
  • - Onglyza
  • - Prandimet
  • - Rosiglitazone
  • - Short-acting regular insulin
  • - Sulfonylureas
  • - Symlin
  • - Tradjenta
  • - Victoza
  • - Welchol
Decision Resources Group brands include: