Real-World Persistence, Adherence, Health Care Resource Utilization, and Costs in People with Type 2 Diabetes (T2D) Switching from Basal Insulin (BI) to Second-Generation BI (Insulin Glargine 300 U/mL [Gla-300]) vs. First-Generation BI (Insulin Glargine 1

This retrospective observational study using the Optum Clinformatics claims database included data from adults (≥18 y) with T2D who had received prior basal insulin (BI) (NPH, Gla-100, IDet) in the 6-month baseline period, and switched to either the second-generation (2nd-gen) BI, Gla-300 or a first-generation (1st-gen) BI (Gla-100, IDet) (treatment switch=index date) between April 1, 2015 and August 31, 2019. Participants were followed from index date for 12 months or plan disenrollment or death. Cohorts were propensity score matched (PSM) on baseline demographic/clinical characteristics. Outcomes were persistence (days on treatment without discontinuation), adherence (proportion days covered), healthcare resource utilization and costs. After PSM (n=3077/cohort; mean age 68 y, 52% female), cohorts were well balanced except for 1 variable (hospitalization) with standardized difference >0.1, which was adjusted in models as a covariate. During the 12-month follow-up period, higher proportions of participants who received Gla-300 vs. 1st-gen BI were persistent (45.5 vs. 42.1%; adjusted p=.0001) and adherent (42.8 vs. 38.2%; adjusted p=.0006). All-cause healthcare resource utilization was lower for Gla-300 vs. 1st-gen BI (emergency room visits 111.9 vs. 148.8 events per 100 patient-years [PY]; inpatient hospitalizations 45.3 vs. 65.9 events per 100 PY; adjusted p<.0001). Total healthcare costs were numerically lower for Gla-300 vs. 1st-gen BI ($41,255 vs. $45,316 per PY). Switching to Gla-300 was associated with significantly better persistence, adherence, and—despite these associated costs—lower all-cause healthcare resource utilization vs. switching to a 1st-gen BI, in people with T2D previously treated with BI therapy. This is the first study to assess these outcomes in tandem. Disclosure E. Wright: Advisory Panel; Self; Abbott Diabetes, Bayer Healthcare Pharmaceuticals Inc., Boehringer Ingelheim International GmbH, Sanofi, Consultant; Self; Abbott Diabetes, Boehringer Ingelheim Pharmaceuticals, Inc., Other Relationship; Self; American Diabetes Association, Speaker’s Bureau; Self; Bayer Healthcare Pharmaceuticals Inc., Sanofi. J. Gill: Employee; Self; Sanofi US, Other Relationship; Self; American Diabetes Association, Stock/Shareholder; Self; Sanofi US. S. Huse: Consultant; Self; Sanofi US. X. Li: Employee; Self; Sanofi US. T. Reid: Other Relationship; Self; Sanofi US. F. L. Zhou: Employee; Self; Sanofi, Stock/Shareholder; Self; Sanofi. Funding Sanofi US