LEVEMIR FLEXTOUCH (Insulin detemir) 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 LEVEMIR FLEXTOUCH, 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. LEVEMIR FLEXTOUCH (Insulin detemir) is a long-acting basal insulin indicated to improve glycemic control in patients 1 year of age and older with type I or type II diabetes. Studies have shown that the insulin mechanism of the FlexTouch pen resulted in lower injection force compared to its competitors. Dexur’s analysis of Real-World Evidence based on Medicare Claims data showed that the use of LEVEMIR FLEXTOUCH (Insulin detemir) 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

   • Type II Diabetes who dispensed LEVEMIR FLEXTOUCH (Insulin detemir) within 7 Days of Hospitalization using Part D drugs claims database

   • Type II Diabetes patients who did not dispense LEVEMIR FLEXTOUCH (Insulin detemir) within 7 Days of Hospitalization

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

Results:

Overall, LEVEMIR FLEXTOUCH (Insulin detemir) was associated with lower hospital readmission rates for all Primary ICD Diagnosis Codes examined. For patients whose primary ICD Diagnosis was “Type II diabetes mellitus with hyperglycemia” (E1165) and when LEVEMIR FLEXTOUCH (Insulin detemir) was used within 7 days of hospitalization, the readmission rate was 15.37% compared to the cohort whereLEVEMIR FLEXTOUCH (Insulin detemir) was not used, whose readmission rate was 22.91%. The readmission odds ratio for these cohorts was 0.61. The use of LEVEMIR FLEXTOUCH (Insulin detemir) was associated with a 39% 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 LEVEMIR FLEXTOUCH (Insulin detemir) is shown below.

Primary ICD Diagnosis Code	Primary ICD Diagnosis Code Description	Total Hospitalizations without LEVEMIR FLEXTOUCH	Readmission Without LEVEMIR FLEXTOUCH	Readmission Rate without LEVEMIR FLEXTOUCH	Total Hospitalizations with LEVEMIR FLEXTOUCH	Readmission with LEVEMIR FLEXTOUCH	Readmission Rate with LEVEMIR FLEXTOUCH	Readmission Odds Ratio	Reduction in Readmission with LEVEMIR FLEXTOUCH (%)	Confidence Interval (-)	Confidence Intervals (+)
E1165	Type II diabetes mellitus with hyperglycemia	13,472

​​Dexur also leveraged Medicare claims data to understand what percentage of patients hospitalized with Pneumonia at major Hospitals were not prescribedLEVEMIR FLEXTOUCH (Insulin detemir) within 7 days of discharge.

ICD CODE	Hospital	Hospitalizations with Type 2 Diabetes	% of Hospitalizations without LEVEMIR FLEXTOUCH
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%

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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 LEVEMIR FLEXTOUCH (Insulin detemir) within 7 days of hospitalization can lead to substantial reductions in hospital readmission rates of Type II Diabetes patients.