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Late Breaking Poster Presentations: Clinical Diabetes/Therapeutics

144-LB: Medicaid Expansion and Utilization of Antihyperglycemic Therapies

  1. ANDREW SUMARSONO,
  2. LEO BUCKLEY,
  3. SARA R. MACHADO,
  4. RISHI K. WADHERA,
  5. HAIDER WARRAICH,
  6. RISHI J. DESAI,
  7. BRENDAN M. EVERETT,
  8. DARREN K. MCGUIRE,
  9. GREGG C. FONAROW,
  10. JAVED BUTLER,
  11. AMBARISH PANDEY and
  12. MUTHIAH VADUGANATHAN
  1. Dallas, TX, London, United Kingdom, Boston, MA, Los Angeles, CA, Jackson, MS
Diabetes 2020 Jun; 69(Supplement 1): -. https://doi.org/10.2337/db20-144-LB
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Abstract

Background: Certain antihyperglycemic therapies modify CV disease courses in DM, but their uptake in practice appears limited among low-income adults.

Methods: We employed a difference-in-difference (DiD) design to study the association between Medicaid Expansion and non-insulin antihyperglycemic prescriptions. We used 2012-2017 National and State Medicaid data to compare prescription claims between states that did (n=25) and did not expand (n=26) Medicaid by Jan 2014.

Results: Following Medicaid Expansion, average quarterly non-insulin antihyperglycemic therapies/1000 enrollees increased by 4% in expansion and 2% in non-expansion states (left panel) with modest variation (right panel). Use of SGLT2i and GLP-1RA grew faster in early expansion than non-expansion states. DiD estimates for prescription change after Medicaid Expansion between expansion vs. non-expansion states was 1.6 (1.00 to 2.20; P<0.001) for all non-insulin therapies, 0.11 (-0.02 to 0.25; P=0.10) for SGLT2i, and 0.11 (0.04 to 0.18; P=0.002) for GLP-1RA. Excluding 7 states that expanded Medicaid after Jan 2014 yielded similar results.

Conclusion: Medicaid Expansion was associated with greater access to non-insulin antihyperglycemic therapies, including GLP-1RA, among newly insured low-income adults, even after accounting for more DM detection. Future studies are needed to understand if policies facilitating these therapeutic changes impact CV health.

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Disclosure A. Sumarsono: None. L. Buckley: None. S.R. Machado: None. R.K. Wadhera: None. H. Warraich: None. R.J. Desai: Research Support; Self; Bayer AG, Novartis AG. B.M. Everett: Consultant; Self; Amarin Corporation, Amgen, Merck & Co., Inc., National Institute of Diabetes and Digestive and Kidney Diseases, Roche Diagnostic USA. Consultant; Spouse/Partner; Sequana. Consultant; Self; U.S. Food and Drug Administration. Research Support; Self; National Heart, Lung, and Blood Institute. D.K. McGuire: Consultant; Self; Afimmune, Applied Therapeutics, Merck Sharp & Dohme Corp., Metavant. Other Relationship; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Eisai Co., Ltd., Eli Lilly and Company, Esperion Therapeutics, Inc., GlaxoSmithKline plc., Janssen Pharmaceuticals, Inc., Lexicon Pharmaceuticals, Inc., Merck & Co., Inc., Novo Nordisk A/S, Pfizer Inc., Sanofi-Aventis. G.C. Fonarow: Consultant; Self; Abbott, AstraZeneca, Janssen Pharmaceuticals, Inc., Medtronic, Novartis Pharmaceuticals Corporation. J. Butler: Consultant; Self; Amgen, Array BioPharma, AstraZeneca, Bayer AG, Boehringer Ingelheim Pharmaceuticals, Inc., Bristol-Myers Squibb, CVRx, G3 Pharmaceuticals, Innolife Co., Ltd., Janssen Pharmaceuticals, Inc., Luitpold Pharmaceuticals, Inc., Medtronic, Merck & Co., Inc., Novartis Pharmaceuticals Corporation, Relypsa, Inc., VIfor. A. Pandey: None. M. Vaduganathan: Advisory Panel; Self; Bayer AG, Boehringer Ingelheim Pharmaceuticals, Inc., Relypsa, Inc. Consultant; Self; Amgen, AstraZeneca, Baxter.

  • © 2020 by the American Diabetes Association
http://www.diabetesjournals.org/content/license

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.

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144-LB: Medicaid Expansion and Utilization of Antihyperglycemic Therapies
ANDREW SUMARSONO, LEO BUCKLEY, SARA R. MACHADO, RISHI K. WADHERA, HAIDER WARRAICH, RISHI J. DESAI, BRENDAN M. EVERETT, DARREN K. MCGUIRE, GREGG C. FONAROW, JAVED BUTLER, AMBARISH PANDEY, MUTHIAH VADUGANATHAN
Diabetes Jun 2020, 69 (Supplement 1) 144-LB; DOI: 10.2337/db20-144-LB

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144-LB: Medicaid Expansion and Utilization of Antihyperglycemic Therapies
ANDREW SUMARSONO, LEO BUCKLEY, SARA R. MACHADO, RISHI K. WADHERA, HAIDER WARRAICH, RISHI J. DESAI, BRENDAN M. EVERETT, DARREN K. MCGUIRE, GREGG C. FONAROW, JAVED BUTLER, AMBARISH PANDEY, MUTHIAH VADUGANATHAN
Diabetes Jun 2020, 69 (Supplement 1) 144-LB; DOI: 10.2337/db20-144-LB
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