Pharmacy & Therapeutics - September 2008 - (Page 535)

Copays and Oral Antidiabetic Drugs Table 1 Coding System for Pre-index Comorbidities, continued Comorbid Conditions ICD-9 or Procedure Code 39.29 39.5 39.9 34101–34111 34201– 34203 35311–35381 35454–35456 35459 35470 35473–35474 35482–35485 35492–35495 35533 35541–35571 35641 35646 35654 75962–75964 75992–75993 93668 433.xx 434.xx 435.xx 436.xx 437.xx 438.xx 278.0x 84.1x 27590–27596 27598 27880–27886 27888 27889 28800–28805 28810–28825 CPT Code Other (peripheral) vascular shunt or bypass Angioplasty or atherectomy of other non-coronary vessel(s) Insertion of non–drug-eluting peripheral vessel stent(s) Embolectomy or thrombectomy, arterial, with or without catheter; by arm incision Embolectomy or thrombectomy, arterial, with or without catheter; by leg incision Thromboendarterectomy Transluminal balloon angioplasty, open; iliac, femoral–popliteal Transluminal balloon angioplasty, open; tibioperoneal trunk and branches Transluminal balloon angioplasty, percutaneous; tibioperoneal trunk or branches, each vessel Transluminal balloon angioplasty, percutaneous; iliac, femoral–popliteal Transluminal peripheral atherectomy, open; iliac, femoral–popliteal, brachiocephalic trunk or branches, tibioperoneal trunk and branches Transluminal peripheral atherectomy, percutaneous; iliac, femoral–popliteal, brachiocephalic trunk or branches, tibioperoneal trunk and branches Bypass graft, with vein; axillary–femoral–femoral Bypass graft, with vein Bypass graft, with other than vein; aortoiliac or bi-iliac Bypass graft, with other than vein; aortobifemoral Bypass graft, with other than vein; axillary–femoral–femoral Transluminal balloon angioplasty, peripheral artery, radiological supervision and interpretation Transluminal atherectomy, peripheral artery, radiological supervision and interpretation Peripheral arterial disease rehabilitation, per session Cerebrovascular disease Occlusion and stenosis of precerebral arteries Occlusion of cerebral arteries Transient cerebral ischemia Acute, but ill-defined, cerebrovascular disease Other and ill-defined cerebrovascular disease Late effects of cerebrovascular disease Obesity Overweight and obesity Amputations Amputation of lower limb Amputation, thigh, through femur, any level Disarticulation at knee Amputation, leg, through tibia and fibula Amputation, ankle, through malleoli of tibia and fibula Ankle disarticulation Amputation, foot Amputation, toe CPT = Current Procedural Terminology; ICD = International Classification of Diseases. ischemic heart disease, prior myocardial infarction or angina, coronary artery bypass graft, angioplasty, congestive heart failure, peripheral vascular disease, cerebrovascular disease, obesity, and amputation). We used a generalized linear model to evaluate the effect of copay on the MPR, adjusting for age, sex, index drug group, provider specialty, region, health insurance type, pre-index (baseline) DCI score, number of unique medications, and use of insulin in the post-index period. This model was also used to evaluate the effect of the MPR on post-index HbA1c measurements, adjusting for pre-index HbA1c, age, sex, index drug group, geographic region, insurance type, pre-index DCI, number of unique medications, insulin use, whether or not the post-index HbA1c measurement was taken more than 90 days after the date of the last fill of the index drug; if so, we determined the time between the last fill and the measurement. SAS version 9.1 (SAS Institute Inc., Cary, NC) was used to perform the statistical analyses. RESULTS Demographics Study criteria were met by 18,658 members. Of these, 8,437 were taking a biguanide, metformin (Glucophage, BristolMyers Squibb); 4,938 were using a sulfonylurea; 4,754 were using TZDs; and 529 were receiving other OADs, including meglitinides or alpha-glucosidase inhibitors. Table 2 presents patient characteristics for the total cohort and by OAD class. The overall mean age was 53 years. There were more women (54%) than men in the study population, which was generally in good health (mean DCI score of 1.3). The most commonly observed comorbidities overall were hypertension (63%), dyslipidemia (48%), and ischemic heart Vol. 33 No. 9 • September 2008 • P&T® 535

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Pharmacy & Therapeutics - September 2008 Contents Editorial Medication Errors Prescription: Washington New Drugs/Drug News/New Medical Devices Drug Forecast Effect of Prescription Copays on Adherence and Treatment Failure with Oral Antidiabetic Medications Vaccine Declinations Present New Challenges for Public Health Universal Health Care in America Digestive Disease Week and American Diabetes Association Pharmaceutical Approval Update

Pharmacy & Therapeutics - September 2008

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