ABSTRACT Aim To investigate adherence to and persistence with free combination therapy (daily basal insulin plus an injectable glucagon‐like peptide‐1 receptor agonist GLP‐1 RA) versus fixed‐ratio combination (FRC) therapy (basal insulin plus a GLP‐1 RA) among individuals with type 2 diabetes (T2D) in Japan. Materials and Methods This retrospective, observational cohort study used DeSC‐IQVIA Integrated claims data from Japan to identify adults (aged ≥ 18 years) with confirmed T2D and ≥ 1 prescription for a GLP‐1 RA (with predefined basal insulin persistence window) or an FRC during October 2019 to September 2023. Study index was date of first GLP‐1 RA or FRC prescription; follow‐up was 365 days. The primary objective was to evaluate adherence to and persistence with free combination therapy versus FRC therapy. Results Age (mean standard deviation) at index was statistically significantly higher in the free combination group (67.0 13.85 years, n = 2063) than in the FRC group (65.7 13.85 years, n = 2386) ( p = 0.002). Odds of optimal adherence at end of follow‐up were statistically significantly higher with FRC therapy than with free combination therapy (adjusted odds ratio 95% confidence interval: 1.96 1.73–2.23; p < 0.001). Risk of discontinuation by end of follow‐up was statistically significantly lower with FRC therapy than with free combination therapy (adjusted hazard ratio 95% confidence interval: 0.66 0.61–0.71; p < 0.001). Adherence and persistence findings were similar in elderly individuals. Conclusions In this real‐world, adult population with T2D in Japan, FRC therapy was associated with improved adherence and persistence versus free combination therapy.
Miyatsuka et al. (Tue,) studied this question.