Table 3

Adjusted percentages of patients receiving prescriptions for each second-line diabetes drug class

%95% CI%95% CI%95% CI%95% CI%95% CI%95% CI
 Overall26.626.5 to to to to 5.247.447.3 to to 4.9
Individual characteristics
 Women26.726.1 to 27.310.19.7 to to to 5.545.344.6 to to 4.6
 Men26.726.1 to to to to 5.449.048.4 to to 5.6
 18–3423.921.4 to 26.411.810.3 to 13.312.410.7 to to to to 5.2
 35–4425.923.8 to 27.910.69.3 to to to 6.243.941.5 to to 5.5
 45–5426.724.7 to to to to 6.245.643.5 to to 5.6
 55–6426.624.7 to to to to 5.947.545.3 to to 6.0
 65–7427.825.8 to to to to 5.450.147.8 to to 6.0
 75+28.025.5 to to to to 3.554.551.8 to to 6.3
Recent healthcare cost level
 Low (below median)24.623.3 to to to to 5.550.549.0 to to 5.8
 High (>95thpercentile)29.628.3 to to to to 6.741.540.1 to to 4.9
 Recent hospitalization23.722.8 to to 7.612.612.0 to to 4.148.747.7 to to 4.7
Charlson Comorbidity Score*
 0 (lowest)20.418.8 to to 13.312.311.0 to to 4.246.344.4 to to 6.3
 127.424.4 to to to to 6.847.243.7 to to 6.2
 2 or 325.922.8 to to to to 6.747.944.4 to to 6.3
 4+ (highest)27.023.7 to to to to 6.448.044.3 to to 6.5
 Diagnosis of obesity†25.725.0 to 26.510.810.3 to to to 6.246.545.6 to to 4.7
Most recent A1c value
 <8%31.329.3 to 33.310.49.2 to to to 7.041.939.7 to to 6.7
 8%–10%31.229.2 to to to to 6.147.845.6 to to 5.7
 >10%23.821.7 to to 6.713.011.3 to to 5.448.946.5 to to 5.2
 Result not available‡25.224.2 to to to to 5.448.347.1 to to 5.3
 Diagnosis of poor control§27.526.8 to to to to 5.445.745.0 to to 4.8
Prescriber characteristics
 Clinical discipline
 Endocrinology28.126.4 to 29.810.69.6 to 11.510.18.9 to to 5.343.241.2 to to 4.3
 Family practice26.625.1 to to to to to to 6.2
 General/Internal27.125.5 to to to to 5.748.546.7 to to 4.9
Proportion of patients for which type 2 diabetes drugs were prescribed¶
 Lowest quartile27.726.8 to to to to to to 5.1
 Highest quartile25.124.2 to to to to 5.845.344.2 to to 5.9
Recent prescribing behavior
 Top quartile of DPP4 use41.139.4 to to to to 6.035.533.7 to to 4.9
 Any GLP1 use28.126.5 to 29.614.713.5 to to to 6.138.837.1 to to 5.3
 Top quartile of INS/B use25.523.7 to to 8.610.39.2 to to 5.847.645.7 to to 4.9
 Any SGLT2 use28.226.9 to to to 9.511.811.2 to 12.438.537.1 to to 5.8
 Top quartile of SFU use20.218.3 to to to to 4.660.958.9 to to 4.3
 Top quartile of TZD use26.925.3 to to to to to 43.910.19.1 to 11.2
Census region where healthcare was received
 Northeast31.630.4 to to to to 5.644.042.6 to to 4.6
 Midwest23.622.4 to to to to 5.451.149.8 to to 5.1
 South26.825.7 to to to to 6.147.446.2 to to 4.8
 West26.425.2 to to to to 5.146.345.0 to to 6.9
Insurance and health plan characteristics
 Insurance category
 Commercial27.426.0 to to to to 6.046.845.2 to to 5.5
 Medicare22.821.4 to to to to 3.652.050.3 to to 6.0
Health plan structure
 Indemnity plan24.020.7 to to to to 8.548.144.5 to to 6.5
 Preferred provider organization25.323.0 to to to to 6.547.444.8 to to 7.0
 Exclusive provider organization25.222.9 to to to to to to 6.5
 Point of service plan26.925.8 to to to to 5.846.845.6 to to 5.4
 Health maintenance organization26.825.5 to to to to 5.048.547.1 to to 5.5
Richness of health plan benefits based on out-of-pocket costs as percent of total costs for all enrollees in the same plan**
 Lowest quartile cost share24.323.2 to to to to 5.749.248.0 to to 5.4
 Highest quartile cost share26.926.0 to to to to 5.946.945.8 to to 5.6
  • All estimates are adjusted for all other covariates in the table; some covariate categories are not included here for space constraints; please see online supplementary appendix for complete classification and adjusted estimates for each variable.

  • *Generally reflects a count of comorbid conditions (higher numbers reflect greater comorbidity).

  • †Reflects a prior encounter with an obesity diagnosis code (see online supplementary appendix for details).

  • ‡Lab values are not routinely available in health plan administrative data sources unless submitted by the laboratory vendor as part of their contract with the health payer; for these data, 38% of submitted laboratory claims nationally included a result.

  • §Reflects a prior encounter for uncontrolled or poorly controlled diabetes (see online supplementary appendix for details).

  • ¶For percentage of prescriptions that were for diabetes: lowest quartile=≤7.7% of patients; highest quartile=≥20.0% of patients. For percent of patient total costs that were out-of-pocket costs: lowest quartile=≤6.1% of total costs; highest quartile=≥11.7% of total costs.

  • **The highest quartile of health plan “richness” corresponds to the plans with the lowest median out of pocket costs, calculated as the percentage of total healthcare costs paid by the patient, rather than by the plan, for all patients in the same plan.

  • DPP4, dipeptidyl peptidase-4 inhibitors; GLP1, glucagon-like peptide-1 receptor agonists; INS/B, long-acting or intermediate-acting insulin given as a basal (rather than mealtime) injection; SGLT2, sodium-glucose cotransporter 2 inhibitors; SFU, sulfonylurea or meglitinides; TZD, thiazolidinediones.