LANTUS SOLOSTAR (Insulin glargine) is associated with Lower Hospital Readmission Rates for Type II Diabetes Patients based on Real World Evidence Study of Medicare Claims Data

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In LANTUS SOLOSTAR, Type II Diabetes

Background:

Type II Diabetes is frequently associated with hospital readmission. Readmission is a hospital quality measure that reflects dimensions of quality of inpatient care and also impacts overall programs by payers such as CMS’s Star Rating Program, HRRP and Value-Based Purchasing. LANTUS SOLOSTAR (Insulin glargine) is a long-acting insulin used to treat adults with type 2 diabetes and adults and pediatric patients (children 6 years and older) with type 1 diabetes for the control of high blood sugar. Studies have shown that LANTUS SOLOSTAR (insulin glargine) used daily reduces the risk of hypoglycemia, which can facilitate more aggressive insulin treatment. Other studies have demonstrated the superiority of LANTUS SOLOSTAR (insulin glargine), and the reduction of the number of hypoglycemic episodes. Dexur’s analysis of Real-World Evidence based on Medicare Claims data showed that the use of LANTUS SOLOSTAR (Insulin glargine) within 7 days of hospitalization was associated with lower hospital readmission rates for Type II Diabetes. Reduction in readmission rates helps hospitals improve their outcomes for various cost and quality programs. Dexur is an approved entity to perform Medicare claims data analysis, which it uses to perform quality outcomes analysis. Dexur has published several papers with Harvard Medical School on quality outcomes related topics. Dexur’s analysis of Drugs and their impact on quality outcomes, such as readmissions and mortality, are used by Hospitals, IDNs, and ACOs to implement best practices and manage Real World Evidence based risk factors.

Methods:

We conducted a retrospective study using Dexur’s analysis of Real-World Evidence from Medicare Claims data, for hospitalizations between January 2019 to September 2019. Our methodology criteria was as follows:

1. Inclusion Criteria: Selected Medical Hospitalizations with Primary Diagnosis with Type II Diabetes codes (Listed in table below)

2. Stratified Selected population into cohorts

   1. Type II Diabetes who dispensed LANTUS SOLOSTAR (Insulin glargine) within 7 Days of Hospitalization using Part D drugs claims database

   2. Type II Diabetes patients who did not dispense LANTUS SOLOSTAR (Insulin glargine) within 7 Days of Hospitalization

3. 30 Day readmission rates were analyzed for both population cohorts

Results:

Overall, LANTUS SOLOSTAR (Insulin glargine) was associated with lower hospital readmission rates for all Primary ICD Diagnosis Codes examined. For patients whose primary ICD Diagnosis was “Type 2 diabetes mellitus with hyperglycemia” (E1165) and when LANTUS SOLOSTAR (Insulin glargine) was used within 7 days of hospitalization, the readmission rate was 17.98% compared to the cohort where LANTUS SOLOSTAR (Insulin glargine) was not used, whose readmission rate was 22.95%. The readmission odds ratio for these cohorts was 0.74. The use of LANTUS SOLOSTAR (Insulin glargine) was associated with a 26% lower readmission rate when used within 7 days of hospitalization. The full list of studied ICD codes, readmission rates, odds ratios, confidence intervals, and percentage reduction in readmission with LANTUS SOLOSTAR (Insulin glargine) is shown below.

Primary ICD Diagnosis Code	Primary ICD Diagnosis Code Description	Total Hospitalizations without LANTUS SOLOSTAR	Readmission Without LANTUS SOLOSTAR	Readmission Rate without LANTUS SOLOSTAR	Total Hospitalizations with LANTUS SOLOSTAR	Readmission with LANTUS SOLOSTAR	Readmission Rate with LANTUS SOLOSTAR	Readmission Odds Ratio	Reduction in Readmission with LANTUS SOLOSTAR (%)	Confidence Interval (-)	Confidence Intervals (+)
E1165	Type 2 diabetes mellitus with hyperglycemia	13,087	3,003	22.95%	951	171	17.98%	0.74	26%	-5.30%	-4.63%
E1110	Type 2 diabetes mellitus with ketoacidosis without coma

​​Dexur also leveraged Medicare claims data to understand what percentage of patients hospitalized with Type 2 Diabetes at major Hospitals were not prescribed LANTUS SOLOSTAR (Insulin glargine) within 7 days of discharge.

ICD CODE	Hospital	Hospitalizations with Type 2 Diabetes	% of Hospitalizations without LANTUS SOLOSTAR
E1165	Montefiore Medical Center, BRONX, NY, 10467	86	88.37%
	AdventHealth Orlando, ORLANDO, FL, 32803	63	84.13%
	Lehigh Valley Hospital - Cedar Crest, ALLENTOWN, PA, 18103	48	79.17%
E1110	AdventHealth Orlando, ORLANDO, FL, 32803	58	82.76%
	Vidant Medical Center, GREENVILLE, NC, 27834	36	72.22%
	Memorial Hermann Hospital System, HOUSTON, TX, 77008	34	70.59%

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Conclusions:

According to analysis of Real-World Evidence of Medicare Claims data, for hospitalizations between January 2019 to September 2019, the use of LANTUS SOLOSTAR (Insulin glargine) within 7 days of hospitalization can lead to substantial reductions in hospital readmission rates of Type II Diabetes patients.