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Type 2 Diabetes Report for 2018

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Type 2 Diabetes Report for 2018 Pittsburgh Business Group on Health TYPE 2 DIABETES REPORT | 2018 Featuring Demographic, Utilization, Charge, and Pharmacotherapy Data With a Focus on Commercial Insurance Coverage 11th Edition MANAGED CARE ® 1987 SINCE DIGEST SERIES www.pbghpa.org PBGH TYPE 2 DIABETES REPORT INTRODUCTION Sanofi U.S. (Sanofi) and the Pittsburgh Business Group on Health (PBGH) are Most of the data in this report (current as of calendar year 2017) were pleased to present the 11th edition of the Type 2 Diabetes Report for 2018, gathered by IQVIA, Durham, NC, a leading provider of innovative health an overview of key demographic, utilization, charge, pharmacotherapy, care data products and analytic services. A review process takes place, and health outcome measures for Type 2 diabetes patients in Pittsburgh before and during production of this report, between IQVIA and Forte and western Pennsylvania (Erie and Johnstown), as well as parts of Ohio Information Resources, LLC. (Youngstown) and West Virginia (Wheeling). The report also provides Sanofi, as sponsor of this report, maintains an arm’s-length relationship supplemental data on patients with cardiovascular conditions as well with the organizations that prepare the report and carry out the research as IQVIA’s state and national benchmarks, which help providers and for its contents. The desire of Sanofi is that the information in this report be employers better identify opportunities to serve the needs of their patients. completely independent and objective. All data are drawn from the Sanofi Managed Care Digest Series®. NOTE: Throughout this report, commercial coverage includes HMOs, PPOs, point-of-service plans, and exclusive provider organizations. PBGH EMPLOYER MEMBERS 84 Lumber Company Civil & Environmental Equipment & Controls, Inc. Mine Safety Appliances Company The Kraft Heinz Company Consultants, Inc. Allegheny County Federal Home Loan Bank Mitsubishi Electric Power Think Communications Inc. Allegheny County Airport Authority Clearview Federal Credit Union of Pittsburgh Products, Inc. Tobii Dynavox Allegheny Technologies Cleveland Brothers Federated Investors, Inc. NEP Group, Inc. American Eagle Outfitters CNX Resources Corporation FedEx Ground Package NOVA Chemicals Inc. Transtar, Inc. System, Inc. Ampco-Pittsburgh Corporation Cognistx Oncology Nursing Society Trib Total Media CONSOL Energy Inc. First Commonwealth Bank API Technolgies Corp. Penn United Technologies, Inc. Triad Metals International ArcelorMittal Tubular Construction & Healthcare First National Bank of PA Peoples Natural Gas Trireme Energy Development, LLC Products USA LLC Consultants FirstEnergy PITT OHIO ATI Flat Rolled Products Covestro LLC Giant Eagle, Inc. Tucker Arensberg Pittsburgh Technical College Baptist Homes Society Cronimet Corporation Industrial Scientific Corporation U. S. Steel and Carnegie PNC Financial Group, Inc. Brinker International Payroll Development Dimensions ITxM Polymer Enterprises Inc. Pension Fund Company, LP International JD Palatine LLC University of Pittsburgh Buchanan Minerals LLC Dick’s Sporting Goods, Inc. Key Bank PPG Industries, Inc. Butler Area School District Dollar Bank, F.S.B. L.B. Foster Company Pressley Ridge Valley Tire Co., Inc. Calgon Carbon Corporation Duquesne Light Company Levin Furniture PSECU Vector Security Duquesne University Reed Smith LLP Carmeuse Lime & Stone MARC USA Wabtec Corporation Carnegie Mellon University Eat’n Park Hospitality Group Matthews International Spang & Company Wesco Distribution, Inc. Carpenter Technology Electronics for Imaging Corporation The Board of Pensions of the Corporation Ellwood Group, Inc. Michael Baker International Presbyterian Church (USA) Westinghouse Electric City of Pittsburgh EQT Corporation Microbac Laboratories Inc. The Hillman Company Company LLC CONTENTS Introduction/Employer Members. 2 Persistency . 11 Patient Demographics . .3–4 Diabetes and Co-Occurring Conditions. 12 A1c Levels . 5 Diabetes and Cardiovascular Disease. 13 Hospital Discharge Data. 6 ACS/Stroke. 14 Professional Charges . 7 Key Findings/ADA Guidelines. 15 Pharmacotherapy. 8–10 Methodology. 16 CONTACTS Diane McClune Melissa Constant Vice President Development Specialist PBGH PBGH P. 724-775-1613 P. xxx-xxx-xxxx E. [email protected] E. [email protected] MANAGED CARE Provided by: Sanofi U.S., Bridgewater, NJ ® 1987 SINCE DIGEST SERIES Developed and produced by: © 2018 Forte Information Resources LLC | Denver, CO | www.forteinformation.com www.managedcaredigest.com Data provided by: IQVIA, Durham, NC 2 PBGH PA TYPE 2 DIABETES REPORT TM | 2018 MANAGED CARE DIGEST SERIES® www.pbghpa.org PATIENT DEMOGRAPHICS DISTRIBUTION OF COMMERCIAL TYPE 2 DIABETES PATIENTS, BY AGE, 2016–2017 AGE 36–64 SHARE OF TYPE 2 DIABETES PATIENTS RISES 0 –17 18–35 36–64 65–79 80+ ACROSS PENNSYLVANIA MARKET 2016 2017 2016 2017 2016 2017 2016 2017 2016 2017 From 2016 to 2017, the share Erie 0.4% 0.5% 2.4% 2.7% 39.9% 42.3% 40.6% 39.8% 16.6% 14.7% of commercially insured Type 2 diabetes patients Johnstown n/a 0.2 1.5 1.4 32.0 35.1 42.2 42.1 24.2 21.2 between the ages of 36 Wheeling 0.2 n/a 1.5 1.8 34.8 38.2 46.0 45.0 17.5 14.9 and 64 edged up, but remained below that of the Youngstown 0.2 0.2 1.8 2.0 38.0 41.6 41.4 40.1 18.6 16.1 nation. Correspondingly, the Pittsburgh 0.2 0.2 1.8 1.8 36.8 38.6 41.9 41.5 19.3 18.0 65-and-over portion of these patients in Pennsylvania 0.6 0.5 2.7 2.6 41.6 43.5 38.4 37.8 16.7 15.6 Pennsylvania declined, but still exceeded NATION 0.4% 0.4% 2.6% 2.7% 46.7% 48.7% 38.0% 36.8% 12.4% 11.4% the U.S. benchmark in 2017. DISTRIBUTION OF COMMERCIAL TYPE 2 DIABETES PATIENTS, BY GENDER, 2017 Male Female 54% 52.7% 52.9% 52.0% 51.6% 51.4% 51.4% 51% 50.5% 49.5% 48.7% 48.6% 48.4% 48% 48.0% 47.3% 47.1% 45% Percentage of Patients 42% Erie Johnstown Wheeling YoungstownPittsburgh Pennsylvania Nation PERCENTAGE OF COMMERCIAL TYPE 2 DIABETES PATIENTS, BY DIAGNOSING SPECIALIST, 2016–2017 Cardiology Endocrinology Internal Medicine Primary Care1 MARKET 2016 2017 2016 2017 2016 2017 2016 2017 Erie 8.9% 8.6% 8.0% 7.4% 12.1% 11.4% 31.0% 30.7% Johnstown 6.5 5.8 1.1 1.2 18.4 16.5 38.3 40.7 Wheeling 7.2 6.5 2.1 2.2 17.0 16.7 41.3 40.1 Youngstown 1.9 1.7 2.6 2.3 23.3 22.9 24.2 25.0 Pittsburgh 5.2 5.0 5.7 5.4 22.1 22.0 30.5 30.4 Pennsylvania 4.5 4.4 5.0 4.8 20.3 20.3 31.3 31.2 NATION 4.0% 3.9% 4.2% 4.0% 23.0% 22.4% 29.6% 29.4% Data source: IQVIA © 2018 1 “Primary care” consists of both general and family practitioners. NOTE: Throughout this report, the Youngstown, OH, market includes Warren and Boardman, and parts of Pennsylvania; the Wheeling, WV, market includes parts of Ohio. An n/a indicates that data were not available. MANAGED CARE DIGEST SERIES® PBGH PA TYPE 2 DIABETES REPORT TM | 2018 3 www.pbghpa.org PATIENT DEMOGRAPHICS PERCENTAGES OF TYPE 2 DIABETES PATIENTS, BY PAYER, 2016–2017 Commercial Insurance1 Medicare Medicaid MARKET 2016 2017 2016 2017 2016 2017 Erie 55.1% 56.2% 31.9% 29.5% 12.7% 14.1% Johnstown 54.8 54.6 36.5 36.0 8.6 9.3 Wheeling 51.8 50.2 36.4 35.8 11.7 13.3 Youngstown 51.2 51.3 33.3 32.5 15.1 16.0 Pittsburgh 58.3 58.5 27.2 27.3 12.3 12.1 Pennsylvania 50.4 49.7 34.2 34.4 14.8 15.3 NATION 50.0% 48.9% 35.7% 35.5% 14.2% 15.4% PERCENTAGES OF TYPE 2 DIABETES PATIENTS, BY PAYER, 2017 Commercial Insurance1 Medicare Medicaid 60% 56.2% 58.5% 54.6% 50.2% 51.3% 49.7% 48.9% 45% 36.0% 35.8% 34.4% 35.5% 32.5% 29.5% 30% 27.3% 14.1% 16.0% 15.3% 15.4% 15% 13.3% 12.1% 9.3% Percentage of Patients 0% Erie Johnstown Wheeling YoungstownPittsburgh Pennsylvania Nation DISTRIBUTION OF COMMERCIAL TYPE 2 DIABETES PATIENTS, BY NUMBER OF COMPLICATIONS, 2016–20172 0 1 2 >2 MARKET 2016 2017 2016 2017 2016 2017 2016 2017 Erie 33.7% 32.4% 25.0% 25.9% 16.9% 16.6% 24.4% 25.1% Johnstown 29.1 27.3 20.8 21.4 18.0 16.4 32.1 34.8 Wheeling 34.1 34.6 21.6 21.8 15.7 14.2 28.6 29.4 Youngstown 34.7 35.1 27.0 26.8 15.1 15.5 23.3 22.6 Pittsburgh 34.8 34.2 25.5 25.5 15.0 14.9 24.7 25.4 Pennsylvania 38.0 37.0 24.6 25.0 14.4 14.5 23.0 23.5 NATION 39.6% 38.9% 25.1% 25.3% 14.0% 14.0% 21.4% 21.8% DISTRIBUTION OF COMMERCIAL TYPE 2 DIABETES PATIENTS, BY NUMBER OF COMORBIDITIES, 2016–20173 0 1 2 >2 MARKET 2016 2017 2016 2017 2016 2017 2016 2017 Erie 32.9% 31.1% 24.2% 23.8% 27.7% 29.1% 15.2% 16.1% Johnstown 18.4 17.8 23.3 22.6 40.2 38.6 18.2 21.0 Wheeling 14.8 16.7 23.4 22.0 41.7 39.5 20.1 21.7 Youngstown 27.4 26.6 28.7 29.9 32.3 31.9 11.6 11.6 Pittsburgh 27.8 28.1 22.6 22.6 30.1 29.0 19.5 20.3 Pennsylvania 26.2 26.7 23.6 23.5 33.6 32.1 16.6 17.7 NATION 22.1% 22.8% 25.8% 25.9% 36.8% 35.5% 15.3% 15.8% Data source: IQVIA © 2018 1 Includes HMOs, PPOs, point-of-service plans, and exclusive provider organizations 2 A complication is defined as a patient condition caused by the Type 2 diabetes of the patient.
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