Purpose

“Me-too” drugs are new pharmaceuticals with the mechanism of action of an existing drug and are considered less innovative than breakthrough drugs. The objective of this study was to evaluate whether the adoption patterns of the breakthrough drug sitagliptin and the “me-too” drug saxagliptin differed and to assess whether the patterns differed between Medicare stand-alone (PDP) and Medicare Advantage Part D (MA-PD) plans.

Methods

Pharmacy claims from a 5% random sample of Medicare Part D beneficiaries were used to identify all prescriptions filled for sitagliptin (breakthrough drug) and saxagliptin (“me-too” drug) between October 1, 2006 and December 31, 2011. The number of new sitagliptin and saxagliptin users by month and type of plan were plotted and Bass diffusion models were constructed to estimate the rate of diffusion.

Results

Sitagliptin had a longer adoption life than saxagliptin, and its adoption was quicker among MA-PD than PDP beneficiaries; it peaked at 51 and 66.7 months after its approval, respectively. However, the adoption of saxagliptin did not differ by type of plan; it peaked at 20.5 months in PDP and 22.9 months in MA-PD. At the end of our study, the market share of the innovative drug sitagliptin measured as the cumulative number of users since market entry was almost nine times higher than the “me-too” drug, saxagliptin.

Conclusions

The breakthrough drug sitagliptin had a much longer adoption life compared to the “me-too” drug saxagliptin, and the breakthrough drug sitagliptin was adopted quicker among managed care plans compared to PDP plans.

中文翻译：

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比较医疗保险受益人中突破性药物和“同类药物”的采用：Depteptidyl Peptidase-4抑制剂的案例研究。

目的

“ Me-too”药物是具有现有药物作用机制的新药物，并且被认为不如突破性药物创新。这项研究的目的是评估突破性药物西他列汀和“我也”药物沙格列汀的采用模式是否不同，并评估独立医疗保险（PDP）和医疗保险优势D部分（MA- PD）计划。

方法

从2006年10月1日至2011年12月31日期间，从Medicare D部分受益人的5％随机样本中获得药房索赔，以鉴定西他列汀（突破性药物）和沙格列汀（“中度”药物）的所有处方。绘制了按月和计划类型划分的西他列汀和沙格列汀的新用户，并建立了Bass扩散模型以估计扩散速率。

结果

西格列汀的收养寿命比沙格列汀长，并且在MA-PD中其接受率比PDP受益者快。批准后，它分别达到了51和66.7个月的峰值。但是，沙格列汀的采用在计划类型上没有差异。PDP在20.5个月达到峰值，MA-PD在22.9个月达到峰值。在研究结束时，以进入市场以来的累计用户数量衡量，创新药物西他列汀的市场份额几乎是“超级”药物萨格列汀的9倍。

结论

与“同类药物”沙格列汀相比，突破性药物西他列汀的采用寿命更长，并且与PDP计划相比，突破性药物西他列汀在管理治疗计划中的采用速度更快。