20 20 MANAGED CARE ® 1987 SINCE DIGEST SERIES Pittsburgh Business Group on Health Type 2 Diabetes Report™ Featuring Demographic, Utilization, Charge, and Pharmacotherapy Data With a Focus on Patients With Commercial Insurance Coverage 13th Edition www.pbghpa.org PBGH TYPE 2 DIABETES REPORT™ INTRODUCTION Sanofi U.S. (Sanofi) and the Pittsburgh Business Group on Health (PBGH) Most of the data in this report (current as of calendar year 2019) were are pleased to present the 13th edition of the Type 2 Diabetes Report™, 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 respiratory conditions as well as IQVIA’s with the organizations that prepare the report and carry out the research state and national benchmarks, which help providers and employers better for its contents. The desire of Sanofi is that the information in this report be identify opportunities to serve the needs of their patients. All data are drawn completely independent and objective. from the Sanofi Managed Care Digest Series®. PBGH EMPLOYER MEMBERS 84 Lumber Company Civil & Environmental Ellwood Group, Inc. Mitsubishi Electric Power Specialty Tires of America Allegheny County Consultants, Inc. Equitrans Midstream Products, Inc. TeleTracking Technologies Allegheny County Airport Authority Clearview Federal Credit Union Equipment & Controls, Inc. MSA The Board of Pensions of the Allegheny Technologies Cleveland Brothers Federal Home Loan Bank NEP Group, Inc. Presbyterian Church (USA) of Pittsburgh NOVA Chemicals Inc. Incorporated CONSOL Energy Inc. The Hillman Company County of Berks Federated Hermes Oncology Nursing Society American Eagle Outfitters The Kraft Heinz Company Ampco-Pittsburgh Corporation Covestro LLC First Commonwealth Bank Penn United Technologies, Inc. Think Communications Inc. API Technolgies Corp. Cronimet Corporation First National Bank of PA Peoples Natural Gas Tobii Dynavox ArcelorMittal Tubular Development Dimensions FirstEnergy PITT OHIO Transtar, Inc. Products USA LLC International Giant Eagle, Inc. Pittsburgh Technical College Triad Metals International Baptist Homes Society Dick’s Sporting Goods, Inc. InventHelp PNC Bank Trib Total Media Brinker International Payroll Dollar Bank, F.S.B. ITxM Point Park University Company, LP Duquesne Light Company K&L Gates PortAuthority U.S. Steel and Carnegie Pension Fund Calgon Carbon Corporation Duquesne University Koppers PPG Industries Carmeuse Lime & Stone Eat’n Park Hospitality Group L.B. Foster Company Pressley Ridge University of Pittsburgh Carnegie Mellon University Eckert Seamans Cherin Levin Furniture PSECU Wabtec Corporation Carpenter Technology & Mellott, LLC Lutheran SeniorLife ReedSmith Wesco Distribution, Inc. Corporation Electronics for Imaging MARC USA SAE International Westinghouse Electric Central Electric Cooperative, Inc. Elite Transit Solutions Michael Baker International Spang Engineered Solutions Company LLC PBGH ALLIED MEMBERS Adagio Health Connected Health Gateway Rehab Allegheny County Schools Health Empower3 Center for Health LLC ZOLL Services LLC Insurance Consortium Excela Health CONTENTS Introduction/Employer Members. 2 Persistency . 11 Patient Demographics . .3–4 Diabetes and Co-Occurring Conditions. 12 Utilization . 5 Diabetes and Cardiovascular Disease. 13 Hospital Discharge Data. 6 Diabetes and Respiratory Conditions . 14 Professional Charges . 7 Key Findings/Heat Map. 15 Pharmacotherapy. 8–10 Methodology. 16 CONTACT Clare Hunter, PharmD/MBA Clinical Account Executive P. 716-849-8298 E. [email protected] MANAGED CARE Provided by: Sanofi U.S., Bridgewater, NJ ® 1987 SINCE DIGEST SERIES Developed and produced by: © 2020 Forte Information Resources LLC | Denver, CO | forteinformation.com managedcaredigest.com Data provided by: IQVIA, Durham, NC 2 PBGH PA TYPE 2 DIABETES REPORT TM | 2020 MANAGED CARE DIGEST SERIES® www.pbghpa.org PATIENT DEMOGRAPHICS PERCENTAGE OF ADULTS SELF-REPORTING DIABETES, BY AGE, PENNSYLVANIA, 2011–2018 25-34 35-44 45-54 55-64 65+ 28% 24.3% 22.9% 23.4% 21.7% 21.5% 20.9% 21.5% 21.4% 21% 17.5% 16.7% 16.8% 16.4% 16.6% 16.3% 14.7% 15.3% 14% 11.7% 11.4% 9.4% 9.4% 9.9% 10.2% 8.3% 8.1% 6.4% 7% 4.9% 4.4% 4.5% 5.0% 5.2% 5.2% 4.6% 1.6% Percentage of Population 1.9% 2.0% 2.1% 2.1% 3.7% 0% 2011 2012 2013 2014 2015 2016 2017 2018 PERCENTAGE OF ADULTS WITH CURRENT SMOKING OR OBESITY, PENNSYLVANIA, 2011–2018 SHARE OF PITTSBURGH TYPE 2 Obesity Smoking DIABETES PATIENTS WITH ≥2 34% COMPLICATIONS RISES 31.6% 30.9% 30.0% 30.2% 30.0% 30.3% More than 44% of commercial 28.6% 29.1% 29% Type 2 diabetes patients in Pittsburgh had two or more 24% 22.4% 21.4% 21.0% complications in 2019, an 19.9% 18.8% 18.1% 18.0% 19% 17.0% increase of 2.7 percentage points from 41.6% in 2017, Percentage of Population 14% 2011 2012 2013 2014 2015 2016 2017 2018 and a higher percentage Data source: Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System © 2020 than either Pennsylvania (39.8%) or the nation (37.4%) DISTRIBUTION OF COMMERCIAL TYPE 2 DIABETES PATIENTS, BY AGE, 2018–2019 in 2019. That year, 11.0% of 0 –17 18–35 36–64 65–79 80+ Pittsburgh Type 2 diabetes MARKET 2018 2019 2018 2019 2018 2019 2018 2019 2018 2019 Erie n/a 0.5% 2.2% 2.0% 49.4% 47.1% 34.5% 36.2% 13.8% 14.4% patients had an A1c greater Johnstown n/a 0.5 1.6 1.4 51.7 48.4 28.8 33.7 17.8 16.1 than 9.0% on their latest Wheeling 0.3% n/a 1.6 1.4 46.1 46.3 38.1 38.2 13.9 14.0 exam, a portion that fell Youngstown 0.3 0.2 1.8 1.9 50.5 48.3 34.1 36.1 13.3 13.5 below that of the nation’s, but Pittsburgh 0.3 0.3 2.0 1.9 48.7 47.4 34.5 36.0 14.6 14.4 exceeded the corresponding Pennsylvania 0.3 0.3 2.0 1.9 52.0 50.4 32.6 34.0 13.1 13.4 Medicare percentage for Pittsburgh (9.5%). NATION 0.3% 0.3% 2.3% 2.3% 56.7% 55.1% 31.3% 32.6% 9.5% 9.8% DISTRIBUTION OF COMMERCIAL TYPE 2 DIABETES PATIENTS, BY GENDER, 2019 Female Male 54% 53.0% 51.6% 51.7% 51.8% 51.6% 51.2% 51.2% 51% 48.8% 48.8% 48.4% 48.3% 48.2% 48.4% 48% 47.0% 45% Percentage of Patients 42% Erie Johnstown Wheeling YoungstownPittsburgh Pennsylvania Nation Data source: IQVIA © 2020 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. Behavioral Risk Factor Surveillance System (BRFSS) data on diabetes are based on responses to the survey question, “Have you ever been told by a doctor that you have diabetes?” Age 25–34 data were not available for 2011 and 2015. BRFSS data on obesity and current smoking status were calculated based on one or more responses to BRFSS questions. MANAGED CARE DIGEST SERIES® PBGH PA TYPE 2 DIABETES REPORT TM | 2020 3 www.pbghpa.org PATIENT DEMOGRAPHICS PERCENTAGE OF TYPE 2 DIABETES PATIENTS, BY PAYER, 2018–2019 Commercial Insurance1 Medicare Medicaid2 MARKET 2018 2019 2018 2019 2009 2019 Erie 24.8% 24.2% 64.6% 65.5% 10.2% 10.1% Johnstown 36.7 39.7 50.8 49.9 12.1 10.3 Wheeling 39.9 43.7 48.7 46.2 10.9 10.0 Youngstown 41.5 43.3 43.7 41.4 14.0 14.6 Pittsburgh 36.8 37.2 52.3 52.3 10.3 10.1 Pennsylvania 34.4 34.4 52.4 52.2 12.6 13.1 NATION 38.5% 38.7% 48.3% 48.7% 12.7% 12.4% PERCENTAGE OF TYPE 2 DIABETES PATIENTS, BY PAYER, 2019 Commercial Insurance1 Medicare Medicaid2 68% 65.5% 52.3% 52.2% 51% 49.9% 48.7% 46.2% 43.7% 43.3% 39.7% 41.4% 37.2% 38.7% 34.4% 34% 24.2% 17% 14.6% 13.1% 12.4% 10.1% 10.3% 10.1% Percentage of Patients 10.0% 0% Erie Johnstown Wheeling YoungstownPittsburgh Pennsylvania Nation PERCENTAGE OF COMMERCIAL TYPE 2 DIABETES PATIENTS WITH ≥2 COMORBIDITIES, 2017–20193 MARKET 2017 2018 2019 Erie 59.9% 54.0% 52.0% Johnstown 62.9 62.1 66.7 Wheeling 68.7 64.5 60.8 Youngstown 61.2 61.6 61.5 Pittsburgh 61.3 62.3 62.7 Pennsylvania 60.5 60.5 59.8 NATION 59.7% 60.2% 59.3% PERCENTAGE OF COMMERCIAL TYPE 2 DIABETES PATIENTS WITH ≥2 COMPLICATIONS, 2017–20194 2017 2018 2019 52% 48.8% 48.0% 46.4% 45.1% 43.8% 43.8% 43.1% 44.3% 41.9% 41.9% 42.5% 41.6% 42.4% 41.0% 41.1% 39.8% 39% 38.4% 38.8% 37.4% 35.7% 36.8% 26% 13% Percentage of Patients 0% Erie Johnstown Wheeling YoungstownPittsburgh Pennsylvania Nation Data source: IQVIA © 2020 1 Includes HMOs, PPOs, point-of-service plans, and exclusive provider organizations. 2 Medicaid includes fee-for-service and managed care.