Cost of cardiovascular diseases and renal complications in people with type 2 diabetes mellitus in the Kingdom of Saudi Arabia: A retrospective analysis of claims database

Abstract

Background The burden of macro- and microvascular complications in patients with Type 2 diabetes mellitus (T2DM) is substantial in Middle East countries. The current study assessed the healthcare resource utilization (HCRU) and costs related to cardiovascular and renal complications among patients with T2DM. Methodology This non-interventional, longitudinal, retrospective, cohort study collected secondary data from three insurance claims databases across Kingdom of Saudi Arabia (KSA) of patients diagnosed with T2DM. The study included adult patients aged ≥18 years diagnosed with first cardiovascular disease (CVD) during index time period and at least one T2DM claim anytime during the study time period. The primary analyses were conducted per database, stratified by three cohorts; patients with at least one claim every six months during the 1-year pre-index and 1-year post-index period (cohort 1), patients with at least one claim every six months during the 1-year pre-index, and two years post-index period (cohort 2) and patients with at least one claim every six months during the 1-year pre-index and 3-year post-index period (cohort 3). For each Payer database, demographics, CVD subgroups, HCRU, and costs were analysed. Descriptive statistics were used to analyse the data. Results The study sample comprised of 72–78% male and 22–28% female T2DM patients with CVD and renal complications. Patients in the age group of 35–65 years or above contributed to the significant disease burden. Nearly 68 to 80% of T2DM patients developed one CVD event, and 19 to 31% of patients developed multiple CVD events during the follow-up period. For most patients with comorbid CVD and renal disease, the average HCRU cost for post‑index periods was higher compared to 1-year pre-index period across the different visit types and activities. Conclusion The study findings elucidates the need for early initiation of therapies that would reduce the long-term cardiovascular and renal outcomes and the associated costs in patients with T2DM.

Cost-Savings Associated with Multi-Disciplinary Team Approach for Reducing Macrovascular and Microvascular Complications in Patients with Type 2 Diabetes: A Predictive Model

“…Around 68–80% of T2DM patients experienced a minimum of one CVD incident and CRF during their lifetime, and 19–31% of them experienced multiple CVD complications. 4 In accordance with a cross-sectional study done in Gulf, CKD (44.3%) and CVD (17.3%) were the most frequently linked to T2DM. 46 …”

“…However, the costs of some complications in the subsequent post-index 10 years were estimated from the previously published relevant literature assuming a uniform distribution (ie, equal costs of complications in each post-index year). 4 , 5 , 15 No discounting was calculated as we assume this constant cost pattern, aiming to determine the lowest predicted cost minimization estimates and be more precise. 21 …”

“… 3 Around ninety percent of all cases of diabetes are Type 2 diabetes mellitus (T2DM). 4 , 5 The increasing prevalence of diabetes in KSA is primarily resulting from population aging, advancing urbanization, and significant shifts in lifestyle in the direction of lack of exercise, increased obesity, rising smoking, high blood pressure, and unhealthy nutrition. 6–8 …”

“…3 Around ninety percent of all cases of diabetes are Type 2 diabetes mellitus (T2DM). 4,5 The increasing prevalence of diabetes in KSA is primarily resulting from population aging, advancing urbanization, and significant shifts in lifestyle in the direction of lack of exercise, increased obesity, rising smoking, high blood pressure, and unhealthy nutrition. [6][7][8] Poor glycemic control may lead to serious macrovascular and microvascular complications including cardiovascular disease (CVD), stroke, diabetic nephropathy, diabetic retinopathy, and diabetic neuropathy (DN).…”

“…7,[20][21][22][23] Many previous studies, utilizing a variety of models, revealed that interventions to prevent or delay the complications of T2DM are translated into cost savings in healthcare expenditures. 4,5,8,[10][11][12]15 The CORE Diabetes Model (CDM) is a validated and updated model that includes risk equations based on long-term follow-up. CDM represents one of the best options for modeling complication incidence and evaluating health economic outcomes among diabetics.…”