Use of more costly diabetes medications varies widely

Use of more costly diabetes medications varies widely
Even within an integrated Veterans Affairs system with a uniform national formulary and established criteria for drug use, there is substantial variation in the use of thiazolidinediones and long-acting insulin analogues among veterans with type 2 diabetes mellitus, according to a research letter published online Oct. 8 in the Archives of Internal Medicine.

(HealthDay)—Even within an integrated Veterans Affairs (VA) system with a uniform national formulary and established criteria for drug use, there is substantial variation in the use of thiazolidinediones and long-acting insulin analogues among veterans with type 2 diabetes mellitus (T2DM), according to a research letter published online Oct. 8 in the Archives of Internal Medicine.

Walid Gellad, M.D., M.P.H., of the VA Pittsburgh Healthcare System, and colleagues conducted a study involving 1,158,809 veterans with T2DM to evaluate the use of high-cost thiazolidinediones (rosiglitazone, pioglitazone) and long-acting (detemir, glargine) in the fiscal year 2009.

The researchers found that 78.3 percent of the patients received prescriptions for diabetes medications: 66.7 percent received an oral medication, 27.7 percent received insulin, and 16.1 percent received both. Thiazolidinedione use ranged from 1.4 to 25.4 percent across the 139 facilities, with a median of 8.2 percent. The median adjusted percentage of patients receiving insulin who used long-acting analogues was 40.6 percent, but ranged from 4.0 to 71.2 percent.

"While some variation is expected given reasonable differences in prescribing practices, the observed 18-fold variation across facilities was unexpected," the authors write. "Our findings suggest that while they may exert powerful effects on medication choice, formularies and utilization management tools can only go so far in standardizing ."

Several authors are employees of the VA.

More information: Full Text (subscription or payment may be required)

add to favorites email to friend print save as pdf

Related Stories

Absolute incretin effect reduced in type 2 diabetes

Jun 25, 2012

(HealthDay) -- For patients with type 2 diabetes mellitus (T2DM) the absolute incretin effect is reduced compared with healthy individuals, but its relative importance is increased, particularly in first-phase ...

Recommended for you

Study explores effects of metformin in obese children

Dec 18, 2014

(HealthDay)—For obese hyperinsulinemic children, metformin seems to decrease perceived hunger and increase perceived fullness, according to a study published online Dec. 8 in Diabetes, Obesity and Metabolism.

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.