Cardiovascular event incidence and cost in type 2 diabetes mellitus: a Medicare claims-based actuarial analysis

Fitch, Kate; Engel, Tyler; Sander, Stephen; Kuti, Effie; Blumen, Helen

doi:10.1080/03007995.2017.1346595

Cited by 11 publications

(9 citation statements)

References 18 publications

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“…More than 10% of these patients had diabetes-related complications at baseline, which indicates that people may have had diabetes-related complications prior to receiving a diagnosis of diabetes. In general, our estimates are higher than those in epidemiology data published in developed countries, including the UK [21], the USA [22], and Germany [23], even given the similar or even younger mean ages in these study populations. Definitions and/or diagnoses criteria of complications were not standardized in these earlier study, which is why we clarified the identification process in detail, including the ICD codes and primary or secondary diagnoses criteria we used.…”

Section: Discussioncontrasting

confidence: 87%

Direct Medical Costs of Incident Complications in Patients Newly Diagnosed With Type 2 Diabetes in China

Zhang

Zhou

et al. 2020

Diabetes Ther

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Introduction Reliable country-specific incidence and cost data on diabetes-related complications are essential inputs for the projections of the economic burden of diabetes. The aim of this study was to provide patient-level cost estimates of managing and treating complications in patients newly diagnosed with type 2 diabetes mellitus (T2DM) in China. Methods Patients newly diagnosed with T2DM in the Tianjin Urban Employee Basic Medical Insurance Claims database between 2008 and 2015 were identified and followed up. The cumulative incidence and descriptive costs of certain macrovascular and microvascular complications were examined. A generalized estimating equations model was used to estimate the immediate- and long-term costs for the incident complication in quarterly intervals, controlling for demographics and the confounding effects of comorbid complications. Results A total of 114,847 newly diagnosed patients were identified (mean age 56.9 years, 45.5% women). After 7 years, 80.8% of the patients at risk had developed nephropathy and 75.7% had developed neuropathy. The immediate additional costs were highest for myocardial infarction during the quarterly interval that the complication first occurred (China yuan [CNY] 19,633), and the long-term costs were highest for stroke in the quarterly intervals of subsequent years (CNY 1087). The expected costs for all complications were calculated and presented as costs per quarterly interval and per year for different age and sex subgroups. Conclusions Managing complications results in substantial costs to the Chinese healthcare system. Our study contributes towards quantifying the economic burden and supports the parametrization of economic models of diabetes in China. Electronic supplementary material The online version of this article (10.1007/s13300-020-00967-y) contains supplementary material, which is available to authorized users.

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Section: Discussioncontrasting

confidence: 87%

Direct Medical Costs of Incident Complications in Patients Newly Diagnosed With Type 2 Diabetes in China

Zhang

Zhou

et al. 2020

Diabetes Ther

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“…27 In line with our study, the differences between the two cohorts were minimal. A study in the USA 40 found that the total average cost was 2.2 times higher in patients with T2DM versus non-DM. However, although the incidence of vascular complications was higher in the T2DM group, the average cost per CV event was similar between groups.…”

Section: Discussionmentioning

confidence: 99%

Incidence and costs of cardiovascular events in Spanish patients with type 2 diabetes mellitus: a comparison with general population, 2015

Artola¹,

García-Moll

Uría

et al. 2020

BMJ Open Diab Res Care

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IntroductionCardiovascular (CV) disease affects a high percentage of patients with type 2 diabetes mellitus (T2DM), especially in the hospital setting, impacting on mortality, complications, quality of life and use of health resources. The aim of this study was to estimate the incidence, mean length of hospital stay (LOHS) and costs attributable to hospital admissions due to CV events in patients with T2DM versus patients without diabetes mellitus (non-DM) in Spain.Research design and methodsRetrospective observational study based on the Spanish National Hospital Discharge Database for 2015. Hospital admissions for patients aged ≥35 years with a diagnosis of CV death, non-fatal acute myocardial infarction (AMI), non-fatal stroke, unstable angina, heart failure and revascularization were evaluated. The International Classification of Diseases, Ninth Revision (250.x0 or 250.x2) coding was used to classify records of patients with T2DM. For each CV complication, the hospital discharges of the two groups, T2DM and non-DM, were precisely matched and the number of hospital discharges, patients, LOHS and mean cost were quantified. Additional analyses assessed the robustness of the results.ResultsOf the 276 925 hospital discharges analyzed, 34.71% corresponded to patients with T2DM. A higher incidence was observed in all the CV complications studied in the T2DM population, with a relative risk exceeding 2 in all cases. The mean LOHS (days) was longer in the T2DM versus the non-DM group for: non-fatal AMI (7.63 vs 7.02, p<0.001), unstable angina (5.11 vs 4.78, p=0.009) and revascularization (7.96 vs 7.57, p<0.001). The mean cost per hospital discharge was higher in the T2DM versus the non-DM group for non-fatal AMI (€6891 vs €6876, p=0.029) and unstable angina (€3386 vs €3304, p<0.001).ConclusionsPatients with T2DM had a higher incidence and number of hospital admissions per patient due to CV events versus the non-DM population. This generates a significant clinical and economic burden given the longer admission stay and higher costs associated with some of these complications.

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“…Besides the pain, suffering and inconvenience to the affected individual, there is also a significant financial burden of T2DM both for the individual and for society. Cost-of-illness studies in different regions show that the medical expenses for people with T2DM are 2-to 4-fold higher than for people not suffering from this condition (4)(5)(6) . For example, about 10 % of healthcare expenses in Germany are spent on the medical care of people with T2DM.…”

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confidence: 99%

Dietary intake of phloridzin from natural occurrence in foods

Niederberger¹,

Tennant

Bellion

2020

Br J Nutr

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Type 2 diabetes mellitus (T2DM) is one of the major diseases of our times. Besides being a considerable inconvenience for the patient, the associated healthcare expenses are tremendous. One of the cornerstones of T2DM prevention is a healthy diet, including a variety of fruits and vegetables. Apples are touted to have health benefits, and the apple polyphenol, phloridzin, has gained interest in recent years as it can reduce intestinal sugar uptake by inhibition of the Na/glucose cotransporter 1. By researching the amount of phloridzin in different food sources and linking them to their consumption data, we could estimate the average and high-level phloridzin consumption in Europe. On average, European people consume 0·7–7·5 mg/d phloridzin, the main contributors being apples and apple juice. High-level consumers may get up to 52 mg/d of phloridzin. Older people are more at risk of developing T2DM, yet they consume less phloridzin than adolescents and adults, as determined by our survey. Management of blood glucose levels might be improved by the consumption of phloridzin, as has been shown in recent clinical trials; these trials used phloridzin-enriched apple extract at doses exceeding those from normal food consumption. There are, however, indications that consumption of average to high levels of phloridzin via food might also contribute to reduced sugar load and a reduction in T2DM risk.

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Cardiovascular event incidence and cost in type 2 diabetes mellitus: a Medicare claims-based actuarial analysis

Abstract: Cardiovascular events in Medicare fee-for-service beneficiaries with T2DM contribute substantially to Medicare cardiovascular events, resource utilization, and cost.

Cited by 11 publications

References 18 publications

Direct Medical Costs of Incident Complications in Patients Newly Diagnosed With Type 2 Diabetes in China

Direct Medical Costs of Incident Complications in Patients Newly Diagnosed With Type 2 Diabetes in China

Incidence and costs of cardiovascular events in Spanish patients with type 2 diabetes mellitus: a comparison with general population, 2015

Dietary intake of phloridzin from natural occurrence in foods

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