Evaluating Medication Day Supply for Improving Clinical Markers of Hemoglobin A1c; Blood Pressure; and Low-Density Lipoprotein

Abstract

Specific Aims: To evaluate whether a 90-day-supply of medication compared to a < 90-day-supply improves clinical biomarkers for hemoglobin A1c (HbA1c), systolic blood pressure (SBP) and low-density lipoprotein (LDL). Subjects: Patients diagnosed with type II diabetes, hypertension or hyperlipidemia. Methods: A retrospective chart review using insurance claims data from 2017. Patients had prescription claims for an oral hypoglycemic agent (OHA), an angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB), and/or a statin. Data were categorized based on the minimum value for control determined by the CMS Star rating system provided to the health plan. Clinical biomarker cutoffs were HbA1c (<9% or ? 9%), SBP (? 140 mm Hg and >140 mm Hg) and LDL (<100 mg/dl or ?100 mg/dl). Main Results: Of the 273 charts reviewed, 251 were included in analysis: 159 females (mean age 64.9; SD = 11.7) and 92 males (mean age = 61.5; SD = 11.3). Patients with medications from multiple classes were included in more than one analysis. With an OHA 76% had a HbA1c of <9% in the < 90-day-supply and 88% in the 90-day-supply group (p-value = 0.14). With ACE/ARB, 57% had an SBP of <140 mm Hg in < 90-day-supply and 71% for a 90-day-supply (p-value = 0.10). With statins 57% had an LDL of <100 mg/dl in the < 90-day-supply group and 66% for a 90-day-supply (p-value = 0.21). Conclusion: This study found that days' supply did not have a statistically significant impact on improving clinical biomarkers HbA1c, SBP and LDL.