Cost analysis of type 2 diabetes mellitus treatment in economically developed countries

Ramzan, Sara; Timmins, Peter; Hasan, Syed Shahzad; Babar, Zaheer‐Ud‐Din

doi:10.1080/14737167.2018.1513790

Cited by 20 publications

(16 citation statements)

References 36 publications

(79 reference statements)

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“…They also had higher costs for medications and were to a greater extent treated with insulin. Similar to the results of this study, previous research has found that CVD in patients with T2D contributes significantly to treatment costs [2,9,11]. Htay et al [10] pointed out that although mortality and prevalence of CVD among diabetics have decreased in recent years, they are still twofold higher than in nondiabetics.…”

Section: Discussionsupporting

confidence: 89%

“…Diabetes is a complex chronic disease, and its prevalence is steadily increasing over time [1]. According to recent reports, diabetes affects one in 11 adults, or about 425 million people globally [2]; of these, approximately 90-95% have type 2 diabetes (T2D) [3]. The prevalence of T2D in Sweden has been reported to be approximately 5% of the adult population [4], which is a prevalence of about 4% of the general population.…”

Section: Introductionmentioning

confidence: 99%

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Disease Burden and Healthcare Costs for T2D Patients With and Without Established Cardiovascular Disease in Sweden: A Retrospective Cohort Study

et al. 2020

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Introduction: Type 2 diabetes (T2D) is a complex chronic disease with an increasing prevalence worldwide. It is commonly associated with complications, such as cardiovascular disease (CVD). Patients with both T2D and established CVD are exposed to increased risk of further cardiovascular events, which means increased healthcare costs and impairments to quality of life and survival. To determine the added burden of CVD for T2D patients, we have analyzed the consumption and costs of healthcare and mortality in two T2D patient cohorts, with and without established CVD, respectively, during a 5-year follow-up in a Swedish region. Methods: Patients with T2D on 1 January 2012 were identified using the administrative database of Region Ö stergötland and the Swedish National Diabetes Register. Established CVD was defined as the presence of a CVD-related healthcare visit in the period 2002-2011. Identified T2D patients were then followed retrospectively for 5 years (2012)(2013)(2014)(2015)(2016) and data collected on utilization of healthcare resources, healthcare costs, and survival. Data pertinent to the study were retrieved from regional databases and national registries. Results: On the index date (1 January 2012) there were 19,731 patients with T2D (prevalence 4.5%) in Region Ö stergötland, of whom 5490 had established CVD. Those patients with established CVD were older, more often men, and had longer diabetes duration and worse kidney function than those without. Compared to T2D patients without CVD, those with CVD had a significantly higher healthcare consumption, experienced higher costs, and had lower survival during the follow-up. Conclusion:This study confirms that established CVD is common among patients with T2D (approximately 30%). Established CVD has negative effects on the utilization of healthcare resources, healthcare costs, and mortality. It is therefore very important to improve the treatment strategy of this patient group.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Disease Burden and Healthcare Costs for T2D Patients With and Without Established Cardiovascular Disease in Sweden: A Retrospective Cohort Study

et al. 2020

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“…Within the diabetes population, over 90% of patients suffer from type 2 diabetes [4,5]. Many patients with type 2 diabetes do not only use diabetes-related care but also use care across the healthcare system for comorbidities, such as chronic obstructive pulmonary disease (COPD) or heart failure [6][7][8][9][10][11][12]. Almost all type 2 diabetes patients utilize medical specialist and pharmaceutical care.…”

Section: Introductionmentioning

confidence: 99%

Delineating the Type 2 Diabetes Population in the Netherlands Using an All-Payer Claims Database: Specialist Care, Medication Utilization and Expenditures 2016–2018

Geurten

Struijs

Elissen

et al. 2021

PharmacoEconomics Open

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Objectives The aim of this study was to describe the healthcare utilization and expenditures related to medical specialist care and medication of the entire type 2 diabetes population in the Netherlands in detail. Methods For this retrospective, observational study, we used an all-payer claims database. Comprehensive data on specialist care and medication utilization and expenditures of the type 2 diabetes population (n = 900,522 in 2018) were obtained and analyzed descriptively. Data were analyzed across medical specialties and for various types of diabetes medication (or glucose-lowering drugs [GLDs]) and other medication. Results Specialist care utilization was diverse: different medical specialties were visited by a considerable fraction of the type 2 diabetes population. Total expenditures on specialist care were €2498 million in 2018 (i.e., 10.6% of the national specialist care expenditures). In total, 97.8% of patients used other medication (not GLDs) and 81.8% used GLDs; 25.6% of medication expenditures were for GLDs. For both specialist care and medication, mean expenditures per treated patient were higher than median expenditures, indicating a skewed distribution of spending. Conclusion Use of and expenditures on specialist care and medication of the type 2 diabetes population is diverse. These heterogeneous healthcare use patterns are likely caused by the presence of comorbidities. Additionally, we found that a small fraction of the population is responsible for a large share of the expenditures. A shift towards more patient-centered care could lead to health improvements and a reduction in overall costs, subsequently promoting the sustainability of healthcare systems.

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“…Metformin is the most commonly prescribed agent for the management of type 2 diabetes worldwide [17]. It has the ability to lower glucose concentrations by reducing hepatic glucose production with a minimal risk of hypoglycaemia.…”

Section: Methodsmentioning

confidence: 99%

Oral antidiabetes agents for the management of inpatient hyperglycaemia: so far, yet so close

et al. 2020

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Background Hyperglycaemia is an ongoing challenge in hospital settings and is associated with poor outcomes. Current recommendations for the management of inpatient hyperglycaemia suggest insulin as the main glucose-lowering treatment choice and limit the administration of oral antidiabetes agents to a small proportion of cases because of safety concerns. Aim To present and critically appraise the available evidence on the use of oral antidiabetes agents in the hospital setting and the risk-benefit balance of such an approach in the era of cardiovascular outcomes trials. Methods PubMed, Embase and Google Scholar databases were searched to identify relevant published work. Available evidence on the efficacy and the safety profile of oral agents in the context of their use in hospitalized individuals are summarized and discussed in this narrative review. Results There is no robust evidence to suggest the use of metformin, thiazolidinediones, sulfonylureas and sodium-glucose co-transporter-2 inhibitors in the hospital setting, although some of their effects on acute outcomes deserve further evaluation in future studies. However, the use of dipeptidyl peptidase-4 inhibitors in inpatients with type 2 diabetes is supported by a few, well-designed, randomized controlled trials. These trials have demonstrated good safety and tolerability profiles, comparable to insulin glucose-lowering efficacy, and a reduction in insulin dose when dipeptidyl peptidase-4 inhibitors are co-administered with insulin, in individuals with mild to moderate hyperglycaemia and a stable clinical condition. Conclusion The administration of dipeptidyl peptidase-4 inhibitors to specific groups of inpatients might be a safe and effective alternative to insulin.

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Cost analysis of type 2 diabetes mellitus treatment in economically developed countries

Cited by 20 publications

References 36 publications

Disease Burden and Healthcare Costs for T2D Patients With and Without Established Cardiovascular Disease in Sweden: A Retrospective Cohort Study

Disease Burden and Healthcare Costs for T2D Patients With and Without Established Cardiovascular Disease in Sweden: A Retrospective Cohort Study

Delineating the Type 2 Diabetes Population in the Netherlands Using an All-Payer Claims Database: Specialist Care, Medication Utilization and Expenditures 2016–2018

Oral antidiabetes agents for the management of inpatient hyperglycaemia: so far, yet so close

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