Costs of Managing Patients with Diabetes in a Large Health Maintenance Organization in Israel: A Retrospective Cohort Study

Porath, Avi; Fund, Naama; Maor, Yasmin

doi:10.1007/s13300-016-0212-9

Cited by 6 publications

(4 citation statements)

References 22 publications

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“…This is likely because individuals showing a poor response to their initial therapies have their doses intensified and move on to other drugs more rapidly than individuals showing a good response. While Porath et al [ 30 ] reported that the impact of HbA1c on costs was limited, our findings are in line with Bennett et al [ 31 ] and Fu et al [ 32 ], who found that increasing HbA1c levels and the lack of a glycaemic response, respectively, were predictors of therapy initiation and escalation.…”

Section: Discussionsupporting

confidence: 91%

Costs and Treatment Pathways for Type 2 Diabetes in the UK: A Mastermind Cohort Study

et al. 2017

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IntroductionMedication therapy for type 2 diabetes has become increasingly complex, and there are few reliable data on the current state of clinical practice. We report treatment pathways and associated costs of medication therapy for people with type 2 diabetes in the UK, their variability and changes over time.MethodsPrescription and biomarker data for 7159 people with type 2 diabetes were extracted from the GoDARTS cohort study, covering the period 1989–2013. Average follow-up was 10 years. Individuals were prescribed on average 2.4 (SD: 1.2) drugs with average annual costs of £241. We calculated summary statistics for first- and second-line therapies. Linear regression models were used to estimate associations between therapy characteristics and baseline patient characteristics.ResultsAverage time from diagnosis to first prescription was 3 years (SD: 4.0 years). Almost all first-line therapy (98%) was monotherapy, with average annual cost of £83 (SD: £204) for 3.8 (SD: 3.5) years. Second-line therapy was initiated in 73% of all individuals, at an average annual cost of £219 (SD: £305). Therapies involving insulin were markedly more expensive than other common therapies. Baseline HbA1c was unrelated to future therapy costs, but higher average HbA1c levels over time were associated with higher costs.ConclusionsMedication therapy has undergone substantial changes during the period covered in this study. For example, therapy is initiated earlier and is less expensive than in the past. The data provided in this study will prove useful for future modelling studies, e.g. of stratified treatment approaches.Electronic supplementary materialThe online version of this article (doi:10.1007/s13300-017-0296-x) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 91%

Costs and Treatment Pathways for Type 2 Diabetes in the UK: A Mastermind Cohort Study

et al. 2017

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“…The main finding of this study was that microvascular complications account for a substantial proportion of HCRU and costs in patients with diabetes and are, therefore, important economic and clinical targets. Crucially, enhanced diabetes care may be capable of preventing their occurrence [ 16 , 17 ]. This study also showed that the economic impact of T2DM microvascular complications increases substantially with the severity of the complication.…”

Section: Discussionmentioning

confidence: 99%

Insights for Care: The Healthcare Utilisation and Cost Impact of Managing Type 2 Diabetes-Associated Microvascular Complications

et al. 2019

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Introduction The increasing prevalence of type 2 diabetes (T2DM) in the UK imposes a significant burden on the National Health Service (NHS). Despite the availability of effective treatments, the loss of glycaemic control over time results in significant comorbidities, including nephropathy, neuropathy and retinopathy. The cost of treating these microvascular complications has not been well documented, and this study aimed to provide an accurate assessment of the healthcare resource utilisation (HCRU) associated with managing T2DM and its complications. Methods This retrospective cohort study utilised electronic medical records from patients with T2DM from the Heart of England Foundation Trust (HEFT), which captures data from patients using secondary care services. Patients were diagnosed with microvascular complications based on ICD-10 or OPCS codes. HCRU over a 2-year period was based on NHS Tariffs for healthcare services for inpatient, accident and emergency, and dialysis clinic usage. Results The study cohort comprised 26,629 patients with T2DM who used HEFT services during the study period, 22.6%, 20.8% and 3.1% of whom had comorbid nephropathy, retinopathy or neuropathy, respectively. While the prevalence of diabetes in the overall HEFT population was reported to be 7% in 2012, diabetes and its associated complications accounted for more than 30% of secondary care costs. Furthermore, while patients with diabetes represent only 17% of HEFT inpatients, they account for more than 20% of service usage. The economic burden of microvascular complications increased substantially with the severity of the condition, with the overall cost exceeding £70 million over the 2-year period. Conclusion This study of patients with T2DM in a typical secondary care provider in the UK showed that avoiding the progression of microvascular complications could provide substantial cost savings through targeted interventions that improve outcomes and lower resource use. Funding Merck Sharp & Dohme Limited. Electronic supplementary material The online version of this article (10.1007/s13300-018-0548-4) contains supplementary material, which is available to authorized users.

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“…Heightened attention to these issues among with diagnosed and possibly undiagnosed diabetes is imperative. Treatment of these unintended and often ignored consequences of COVID-19 could pose a substantial long-run cost burden on the health community [55][56][57][58].…”

Section: Discussionmentioning

confidence: 99%

COVID-19 and Diabetes: Unintended Medical, Financial and Societal Consequences

Jacobs¹,

Services²,

Ellis³

2021

J Diabet Res Rev Rep

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Even In the absence of a pandemic, diabetes is a costly medical condition that can have a devastating impact on older adults. In the current COVID-19 pandemic, the presence of diabetes among adults is well established a risk for longer hospitalizations and likelihood of death. Beyond the direct combined health effects of COVID-19 and diabetes, the added financial strain, absence of regular care due to physician office closures and social isolation has the potential to worsen diabetes outcomes. In this paper, we explore the impact of the COVID-19 pandemic on adults with diabetes and diabetes-related complications. This review considers the financial, social and behavioral consequences of having diabetes during a global pandemic and the long-term health implications for adults residing in a country where reducing your risk for contracting COVID-19 might in turn, increase your risk of worsening long-term health outcomes. It also examines the financial implications of uncontrolled disease spread and the widespread mortality among elderly Americans in conjunction with the combined effects of changes in diet, physical activity and personal care caused by the pandemic.

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Costs of Managing Patients with Diabetes in a Large Health Maintenance Organization in Israel: A Retrospective Cohort Study

Cited by 6 publications

References 22 publications

Costs and Treatment Pathways for Type 2 Diabetes in the UK: A Mastermind Cohort Study

Costs and Treatment Pathways for Type 2 Diabetes in the UK: A Mastermind Cohort Study

Insights for Care: The Healthcare Utilisation and Cost Impact of Managing Type 2 Diabetes-Associated Microvascular Complications

COVID-19 and Diabetes: Unintended Medical, Financial and Societal Consequences

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