Adherence, duration and healthcare costs in a real-world population of patients with acromegaly
Publication: Journal of Comparative Effectiveness Research
Abstract
Aim: The aim of this study was to describe treatment patterns among patients with acromegaly who are newly treated with acromegaly medical therapy. Materials & methods: Data from IQVIA Pharmetrics Plus® Database from 1 January 2013 to 30 June 2023 were used to identify patients with acromegaly who started a new acromegaly medical therapy and observe their treatment patterns. Patients were required to have at least 12 months of data without any acromegaly therapy (medication or surgery) prior to the index date and at least 6 months of follow-up. Comorbidities were measured during the baseline period. Adherence, persistence, medication and switching were measured during follow-up. Results: A total of 453 patients with acromegaly who were newly treated with acromegaly medical therapy and had no evidence of acromegaly therapy for at least 12 months were identified. Among these patients, 46.1% (n = 206) were treated with cabergoline as their index treatment, 24.5% (n = 111) with injectable octreotide, 15.0% (n = 68) with lanreotide, 5.5% (n = 25) with bromocriptine, 4.9% (n = 22) with pegvisomant, 2.2% (n = 10) with pasireotide, 1.1% (n = 5) with oral octreotide, 0.4% (n = 2) with cabergoline + octreotide, and 0.2% (n = 1) with cabergoline + lanreotide. By the end of the follow-up period, 54.3% (n = 246) were not on any treatment, 19.6% (n = 89) remained on the index treatment, and the remaining 26.0% (n = 118) switched to another treatment. Conclusion: This study contributed to the growing evidence that patients with acromegaly are not well-served by current therapeutic options, as indicated by high rates of treatment discontinuation, switching and add-on therapy. However, treatment switching and add-on therapy represent ongoing efforts to optimize patient care toward more effective and tolerable treatments. Expanded treatment options may serve an unmet need in this patient population.
Plain language summary
What is this article about?
Acromegaly is a rare, chronic condition caused by high hormone levels and results in soft tissue growth, joint pain, hypertension, diabetes and increased risk of mortality. In this study, the aim was to investigate medication persistence (i.e., how long patients stay on a medication), medication adherence (i.e., how consistently patients take their medication as prescribed) and medication switching/add-on therapy (i.e., how often patients use a different medication from the one they were initially prescribed).
What were the results?
We used health insurance claims data from the IQVIA Pharmetrics Plus Database to understand treatments patterns. Patients were not treated with any acromegaly medical therapy for at least 12 months prior to starting the new treatment. All patients were observed for at least 6 months with varying lengths of follow-up. Nearly 80% of patients did not persist with their initial therapy (discontinued [54%] or switched/added-on a medical treatment [26%]) by the end of follow-up.
What do the results mean?
Medication persistence and adherence are important in the management of chronic disease. However, we found that about 80% of patients with acromegaly who were newly treated with medication do not persist with medical therapy. Lack of persistence, when either discontinuing, switching or adding-on, represents opportunities for providers and patients to select therapies that better serve patient needs. These findings highlight the need for expanded treatment options.
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Received: 20 May 2025
Accepted: 26 June 2025
Published online: 8 July 2025
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Adherence, duration and healthcare costs in a real-world population of patients with acromegaly. (2025) Journal of Comparative Effectiveness Research. DOI: 10.57264/cer-2025-0080
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