PCD was associated with higher costs and resource utilization, compared with non-PCD controls, primarily driven by inpatient stays. Treating PCD appropriately before the disease progresses to a level requiring hospitalization may help reduce the costs associated with this disease.

Aims: To evaluate the effect of Federal Drug Administration-cleared computerized insulin dose adjustment algorithms (CIDAAs) incorporated into a Remote Patient Monitoring (RPM) program on HbA1c levels. Material & Methods: Type 2 patients receiving insulin for >6 months with HbA1c levels ≥8.0% enrolled in a Medicare Advantage plan were recruited into 3 arms; Group A (RPM plus CIDAAs, N=40), Group B (RPM but no CIDAAs, N=42), and Group C (usual care with no RPM or CIDAAs, N=33). In Groups A and B, glucose readings of >200 mg/dL and <70 mg/dL triggered alerts and health educators contacted patients for counseling to avoid future episodes. Results: Baseline HbA1c levels (% ± SD) were not statistically different among Groups A (9.5 ± 1.5), B (9.2 ± 1.1) and C (9.0 ± 0.9). At 6 months, HbA1c levels fell twice as much in Group A (-1.5 ± 1.0) as in Groups B (-0.7 ±1.5) and C (-0.7 ± 1.2) (P <0.001). Alerts >200 mg/dl were significantly less in Group A (N=942) than in B (N=1111) (P = 0.002) but alerts <70 mg/dL were not significantly different (235 vs 209). In Group A, baseline per patient daily insulin doses of 78 units rose 40% to 109 units. Six patients in Group C had emergency room visits for hypoglycemia but none in Groups A and B. Conclusions: The RPM program lessened clinical hypoglycemic risk but required CIDAAs to markedly increase insulin doses effectively and safely to significantly lower HbA1c levels twice as much as either RPM alone or usual care.

tient visit for 12 months. Annual average visit days of outpatients were 37. Annual overall costs per patient were 13.4 million Korean won (KRW), of which 10.5 million KRW (78.6%) was drug costs because of costly TNF antagonist. Inspection cost came next with 5.6% of the total costs, followed by hospitalization cost (4.6%), operation cost (4.0%), and doctor's fee (3.2%). Mean out-of-pocket expenditure was 3.7 million KRW, 27.1% of the overall costs. As age increased, so did the total costs. Male, medical aid, and patients with hospitalization or surgery were associated with significantly higher costs than female, health insurance, and inexperienced patients of hospitalization or surgery respectively(pϽ0.05). CONCLUSIONS: Direct medical costs per capita of RA patients receiving TNF antagonist in Korea were 13.4 million KRW. The economic burden of RA patients is strongly influenced by TNF antagonist. OBJECTIVES:To describe the association between serum uric acid (sUA) levels and gout-related healthcare utilization and costs. METHODS: A retrospective analysis was conducted using a database from a regional managed care organization. Patients with primary gout were included in the study if they met the following criteria between 2006 and 2007: (1) age Ն18; (2) Ն1 diagnosis of gout (ICD-9-CM 274.xx), or Ն1 prescription gout-related medications (colchicine, allopurinol, probenecid); (3) 12 months continuous eligibility pre-and post-either the first gout diagnosis or first pharmacy claim date (index date). Patients with cancer diagnoses were excluded. Patients were classified into three sUA levels based on the measurement taken on the date closest to the index date: Ͻ6.0 mg/dL, 6.0-8.99 mg/dL, and Ն9.0 mg/dL. Healthcare costs in the12 months post index period were compared across the three sUA levels using Kruskal-Wallis tests. RESULTS: A total of 1,622 patients were identified; 374 (23.0%) had an sUA Ͻ6.0 mg/dL, 788 (48.0%) had an sUA of 6.0-8.99 mg/dL, and 470 (29.0%) had an sUA Ն9.0 mg/dL. The mean gout-related healthcare costs were $217(standard deviation [SD] $631), $426 (SD $4330), and $647(SD $4274) for patients with sUA Ͻ6.0 mg/dL, 6.0-8.99 mg/dL, and Ն9.0 mg/dL, respectively (pϽ0.0001). Statistically significant differences were also detected in the gout-related outpatient costs, gout-related emergency department costs, and gout-related prescription costs among the three groups. CONCLUSIONS: Our results showed that there is a positive association between sUA levels and gout-related healthcare utilization and costs. Lowering and maintaining sUA levels Ͻ6 mg/dL may lead to lower gout-related healthcare costs and decrease goutrelated utilization of services. Further study is warranted.

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