Predictors of glycemic control and diabetes-related costs among type 2 diabetes patients initiating therapy with liraglutide in the United States
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OBJECTIVE: Liraglutide has been shown to significantly improve glycemic control and reduce body weight while minimizing the risk of hypoglycemia in adult patients with type 2 diabetes (T2D). This study aimed to identify characteristics that predict clinical and economic outcomes associated with liraglutide therapy in clinical practice in the US. METHODS: Using the Truven Health MarketScan Laboratory Database, glycemic control (A1C <7%) and diabetes-related costs were evaluated in T2D patients initiating liraglutide between January 1, 2010 and June 30, 2012. Patients were required to have ≥1 post-index claim for liraglutide and A1C values at baseline and 6 months follow-up. All valid values of baseline A1C were included. Patients previously treated with GLP-1 receptor agonist(s) or insulin, or with evidence of type 1 diabetes, pregnancy, or gestational diabetes during the study period were excluded. Multivariable regression models were used to identify predictors of glycemic control and diabetes-related costs. RESULTS: Of 417 patients newly treated with liraglutide, 54.0% achieved glycemic control (A1C <7%) during follow-up. Factors associated with increased odds of glycemic control during follow-up were: being female, POS/EPO health plan type, baseline A1C, early liraglutide initiation (0-1 prior oral anti diabetics [OADs] vs ≥2), adherence to liraglutide (defined as the proportion of days covered [PDC]), and diabetic retinopathy. Being female, earlier liraglutide initiation (0-1 prior OADs), and higher patient share of liraglutide costs were associated with significantly lower diabetes-related costs during follow-up. Factors associated with significantly higher post-index diabetes-related costs were: higher baseline A1C, baseline use of sulfonylureas, and diabetic retinopathy. CONCLUSIONS: Within this commercially-insured population of T2D patients treated with liraglutide, gender, baseline A1C, early liraglutide initiation (0-1 prior OADs), diabetic retinopathy, better adherence, and patient share of liraglutide costs were associated with increased odds of achieving glycemic control and the odds of having higher or lower diabetes-related costs.
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In an analysis of liraglutide, females were more likely to achieve good glycemic control at follow-up compared to males (OR 1.75); female superiority was identified in the 18-64 age group, while in the over 65 age group male predominance was observed.
“In another analysis investigating the efficacy of liraglutide in reducing Hb1Ac, females were more likely to achieve good glycemic control at follow-up in comparison to males (OR 1.75). Specifically, when stratified by age, female superiority was identified in the 18–64 age group, while in the over 65 age group, male predominance was observed [54].”
From Sex Differences in Response to Treatment with Glucagon-like Peptide 1 Receptor Agonists: Opportunities for a Tailored Approach to Diabetes and Obesity Care (2022) · cites this paper as [54]
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Experimental — accuracy not yet measuredThe literature provides conflicting evidence about a sexual dimorphism in the anti-hyperglycemic effect of GLP-1 RAs in subjects with T2D.
“Currently, the literature provides conflicting evidence about a sexual dimorphism on the anti-hyperglicemic effect of GLP-1 RAs in subjects with T2D.”
From Adipose Tissue: A Novel Target of the Incretin Axis? A Paradigm Shift in Obesity-Linked Insulin Resistance (2024) · cites this paper as [87]
In an analysis of liraglutide efficacy stratified by age, women showed a greater reduction in HbA1c in the 18-64 age group, whereas men predominated in the over 65 age group.
“Analogous conclusions were also reported in another analysis examining the efficacy of liraglutide, which showed that, when stratified by age, women showed a greater reduction in HbA1c values in the 18–64 age group, whereas in the over 65 age group, predominance in men was reported [87].”
From Adipose Tissue: A Novel Target of the Incretin Axis? A Paradigm Shift in Obesity-Linked Insulin Resistance (2024) · cites this paper as [87]
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- Authors
- Durden, E., Lenhart, G., Lopez-Gonzalez, L., Hammer, M., & Langer, J.
- Affiliations
- Truven Health Analytics (United States) (US)
- Novo Nordisk (Denmark) (DK)
- Corresponding author
- Durden, Emily
- Venue
- Journal of Medical Economics
- Publisher
- Informa UK Limited
- Published
- 2016-01-08
- Volume
- 19
- Issue
- 4
- Pages
- 403-413
- ISSN
- 1369-6998 (ISSN-L)
- 1941-837X
- OpenAlex
- W2291309938
- Cited by
- 23
- References
- 24
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 4 · 2022: 2 · 2021: 3 · 2019: 1 · 2018: 2 · 2017: 2
- FWCI
- 1.16
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Medical Economics (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Keywords
- liraglutide, type 2 diabetes, glycemic control, GLP-1 receptor agonists, HbA1c, medication adherence, diabetic retinopathy, sulfonylureas, oral antidiabetic drugs, predictors of treatment outcome, commercially insured patients
- MeSH terms
- Liraglutide, Blood Glucose, Diabetes Mellitus, Type 2, Female, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Male, Retrospective Studies, Sex Factors, United States, Medication Adherence
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