Supplementary materials: Adherence, duration and healthcare costs in a real-world population of patients with acromegaly

<b>These are peer-reviewed supplementary materials for the article</b><b> </b><b>'</b><b>Adherence, duration and healthcare costs in a real-world population of patients with acromegaly</b><b>'</b><b> </b><b>published in the</b><b> </b><b><i>Journal of Comparative Effectiveness Research</i></b><b>.</b><b>Table A: </b>List of CPT and ICD codes for hypophysectomy and stereotactic radiosurgery<b>Table B: </b>List of ICD-9 codes and ICD-10 codes for comorbidities of interest<b>Aim:</b> The aim of this study was to describe treatment patterns among patients with acromegaly who are newly treated with acromegaly medical therapy. <b>Materials &amp;methods: </b>Data from IQVIA Pharmetrics Plus R ?Database from 1 January 2013 to 30 June 2023 were used to identify patientswith 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. <b>Results:</b> 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. <b>Conclusion:</b> 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.