Diabetic Peripheral Neuropathy (DPN)
Conditions
Keywords
Metanx®, diabetes, neuropathy, peripheral neurological disorder, peripheral circulation disorder, folic acid, folate, L-methylfolate, vitamin B6, Pyridoxal 5'-phosphate, vitamin B12, methylcobalamin
Brief summary
This study will be an observational cohort study utilizing administrative claims data with 100 patients randomly selected taking Metanx® meeting the inclusion and exclusion criteria and 400 propensity score matched patients meeting the same criteria to serve as a control cohort for analyses. This data includes medical, and pharmacy claims from the HealthCore Integrated Research Database for claims submitted during the time period of 01/01/2002 through 06/30/2007.
Detailed description
The control patients will be matched at a ratio of 4:1 with the Metanx® patients. Covariates used to select the propensity matched patients will include: age; gender; health plan type and region; DCI score; presence/absence of nephropathy; ischemic heart disease; cerebrovascular disease; neoplasm; insulin use; and all-cause health plan costs in the 6-mont pre-index period. Claims information about patients selected for the study will be followed longitudinally to the end of data availability. This data stream will be used to determine treatment patterns for Metanx®, healthcare resource utilization, and cost.
Interventions
Patient cohort compliant on Metanx® BID therapy for \>120 days
OTHERNot treated with Metanx®
Non-treated comparative cohort
Sponsors
HealthCore, Inc.
Pamlab, L.L.C.
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
25 Years to 80 Years
Healthy volunteers
Yes
Inclusion criteria
* Patients must have pharmacy claims for \>120 continuous days of Metanx®. This will be defined as at least a 90-day supply dispensed within the first 120 days post-index. The first pharmacy claim for Metanx® will be the index date. * Patients must have a diagnosis of diabetes prior to or including the index date. * Patients must have a diagnosis of a peripheral neurological or a peripheral circulation disorder. * Patients must have a diagnosis of lower limb ulcer.
Exclusion criteria
* Patients will be excluded if they have \<18 months of eligibility defined as a minimum of 6 months pre and 12 months post-index eligibility. * Patients will be excluded if they have taken other L-methylfolate containing products (Deplin®, Cerefolin®, Cerefolin NAC®,Neevo®) or other prescription folic acid combination products with \>1mg folic acid.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| All-Cause Health Plan Costs | 12 months post-index period | Total healthcare utilization and costs for patients treated with Metanx® will be compared to total healthcare utilization and costs for control patients who did not receive Metanx®. Cost data will be presented as Mean (SD) and median. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Disease-Attributable Resoure Use and Cost | 12 month post-index period | Disease attributable resource use and costs will be defined as medical claims associated with ICD-9 codes for disease(s) of interest. Total attributable resource use (units) and cost (allowed or paid), if available, will include: pharmacy (medication related to disease of interest); laboratory tests (all claims); office-based encounters and costs; emergency room visits and cost; other outpatient facility (e.g. clinic, home health); in-patient hospitalization; and durable medical equipment. |
| Demographics of Patients Taking Metanx® | >120 continuous days Metanx® therapy | Statistical data including age (at index date); gender; comorbidities; prior and concomitant medications; and Metanx® utilization (e.g. dispensing quantity, number of fills, compliance, and persistency) will be collected to provide a descriptive analysis of the typical Metanx® patient characteristics. |
Countries
United States
Outcome results
None listed