The economic impact of insulin-related hypoglycemia in Denmark: an analysis using the Local Impact of Hypoglycemia Tool

Hoskins, Nicki; Tikkanen, Christian Klyver; Pedersen‐Bjergaard, Ulrik

doi:10.1080/13696998.2016.1269774

Cited by 8 publications

(10 citation statements)

References 22 publications

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“…Varying by ±20% the cost of a GP visit, the percentage of severe episodes treated in hospital for T1DM, and the percentage utilization for GP visits for a non-severe episode in T2DM had the largest effects on the overall results and therefore were the inputs that showed the greatest uncertainty. The cost and utilization of HCP visits (GP and diabetes specialist) were also among the main drivers of the model in an analysis conducted in the UK and Denmark [ 9 , 10 ]. In addition, a study (SECCAID) that estimated the costs of diabetes in Spain reported that 28% of the total corresponds to primary care [ 24 ], further supporting the fact that GP costs are an important part of the cost of diabetes and its associated complications.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, hypoglycemia can result in visits to a general practitioner or diabetes specialist, and additional self-monitoring of blood glucose (SMBG) tests used to assess blood glucose levels following a hypoglycemic episode. These costs have previously been estimated for the UK and Denmark using the Local Impact of Hypoglycemia Tool (LIHT) [ 9 , 10 ]. The aim of this study was to use the LIHT to estimate the cost of insulin-related hypoglycemia in Spain, and to identify the potential cost savings associated with a reduction in hypoglycemia rates.…”

Section: Introductionmentioning

confidence: 99%

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The Economic Burden of Insulin-Related Hypoglycemia in Spain

Parekh

Hoskins²,

Baker‐Knight³

et al. 2017

Diabetes Ther

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IntroductionAn analysis was conducted to estimate the economic burden of insulin-related hypoglycemia in adults in Spain, derived from a novel concept developed for the UK known as the Local Impact of Hypoglycemia Tool.MethodsCosts per severe and non-severe hypoglycemic episode were calculated for patients with type 1 diabetes (T1DM) and type 2 diabetes (T2DM). The costs per episode were applied to the population of adults with T1DM and T2DM using insulin in Spain according to the number of severe and non-severe episodes experienced per year. Costs were calculated using Spanish-specific resource costs and published values for resource utilization, including ambulance, accident and emergency (A&E) department, hospitalization, healthcare professional visits, and extra self-monitoring of blood glucose (SMBG) tests used in the week following the episode. A one-way sensitivity analysis on all model inputs was then performed.ResultsThe cost of insulin-related hypoglycemia in Spain is estimated as €662.0 m per year, €292.6 m of which is due to severe episodes and €369.4 m to non-severe episodes. The cost per episode varies from €1.25 for patients with T1DM and €1.48 for patients with T2DM for a non-severe episode where extra SMBG testing after the episode is the only action taken, to €4378.22 for T1DM and €3005.74 for T2DM for a severe episode that was treated in hospital and requires an ambulance, A&E visit, hospitalization, and a diabetes specialist visit. A reduction in severe and non-severe hypoglycemia rates of just 20% could lead to considerable cost savings of €284,925 per 100,000 general population.ConclusionThis analysis highlights the substantial economic burden of hypoglycemia in Spain, and gives budget holders the ability to assess the costs of new treatments or patient education programs in relation to the potential cost savings due to lower hypoglycemia rates.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Economic Burden of Insulin-Related Hypoglycemia in Spain

Parekh

Hoskins²,

Baker‐Knight³

et al. 2017

Diabetes Ther

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“…11 A number of costof-illness and cost-consequence studies have reported the direct medical costs incurred per severe hypoglycaemic episode across clinical characteristics in developed countries, including the USA, 12-14 the UK, 15,16 Denmark, 17 the Netherlands, 18 Germany, 7 Spain 19,20 and South Korea. 11 A number of costof-illness and cost-consequence studies have reported the direct medical costs incurred per severe hypoglycaemic episode across clinical characteristics in developed countries, including the USA, 12-14 the UK, 15,16 Denmark, 17 the Netherlands, 18 Germany, 7 Spain 19,20 and South Korea.…”

Section: Introductionmentioning

confidence: 99%

“…On a global scale, SH imposes a substantial economic burden on national healthcare services, driven by an increasing need for blood glucose monitoring, emergency services, hospitalization and additional visits to doctors and allied health professionals. 11 A number of costof-illness and cost-consequence studies have reported the direct medical costs incurred per severe hypoglycaemic episode across clinical characteristics in developed countries, including the USA, [12][13][14] the UK, 15,16 Denmark, 17 the Netherlands, 18 Germany, 7 Spain 19,20 and South Korea. 21 While the mean costs of an SH episode can be estimated, there is a scarcity of information to date concerning costs during the preceding and subsequent years.…”

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confidence: 99%

“…The major driver of total direct medical costs for matched controls was outpatient visits, a small proportion of which were emergency visits, and the use of allied health Spanish population 17,33. The costs were similar to those for T2DM patients in Denmark,17 but were less than those for T2DM patients in the UK 16. Comparing patients who use or do not use metformin, direct medical costs during the SH event year for those using metformin were lower than those not using metformin.…”

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Direct medical costs in the preceding, event and subsequent years of a first severe hypoglycaemia episode requiring hospitalization: A population‐based cohort study

Wong

Tong

Cheng

et al. 2019

Diabetes Obesity Metabolism

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Aims:We aimed to estimate the use of healthcare services and the direct medical costs accrued by patients with diabetes mellitus (DM) during the year of the first severe hypoglycaemia (SH) event, as well as during the years before and after the event year. Materials and Methods:We analysed a population-based, retrospective cohort including all adults with DM managed in the primary care setting from the Hong Kong Hospital Authority between 2006 and 2013. DM patients for whom SH was first recorded during the designated period were identified and matched to a control group of patients who had not experienced an SH event using the propensity score method. Direct medical costs in the years before, during and after the first SH event were determined by totalling the costs of health services utilized within respective years.Results: After matching, a total of 22 694 DM patients were divided into the first recorded-SH group (n = 11 347) and the non-SH control group (n = 11 347). Patients for whom SH was first recorded, on average, made 7.85 outpatient clinic visits, made 1.89 emergency visits and spent 17.75 nights hospitalized during the event year. Mean direct medical costs during the event year were 11 751 US$, more than 2-fold that during the preceding year (4846 US$; P < 0.001) and subsequent years (4198-4700 US$; P < 0.001) and was 4.5 times that 2 years before the event (2481 US$; P < 0.001). Incremental costs of SH patients vs matched controls during the event year and the preceding year were 10 873 US$ (P < 0.001) and 3974 US$ (P < 0.001), respectively.Conclusions: SH is associated with excessive hospital admission rates and direct medical costs during the event year and, in particular, during the year before as compared to patients who had not experienced an SH event. K E Y W O R D Scohort study, diabetes mellitus, direct medical cost, healthcare utilization, severe hypoglycaemia

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The Economic Burden of Insulin-Related Hypoglycemia in Adults with Diabetes: An Analysis from the Perspective of the Italian Healthcare System

Parekh

Streeton²,

Baker‐Knight³

et al. 2018

Diabetes Ther

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IntroductionThe aim of this analysis was to estimate the cost of insulin-related hypoglycemia in adult patients with diabetes in Italy using the Local Impact of Hypoglycemia Tool (LIHT), and to explore the effect of different hypoglycemia rates on budget impact.MethodsDirect costs and healthcare resource utilization were estimated for severe and non-severe hypoglycemic episodes in Italy and applied to the population of adults with type 1 diabetes (T1DM) and type 2 diabetes (T2DM) and their corresponding hypoglycemia episode rates (0.49 severe and 53.3 non-severe episodes per year for T1DM, and 0.09 severe and 9.3 non-severe episodes per year for T2DM). Uncertainty around model inputs was explored through sensitivity and scenario analyses.ResultsThe direct cost of insulin-related hypoglycemia in Italy is estimated at €144.7 million per year, with €65 million attributable to severe episodes and €79.6 million due to non-severe episodes. The total cost of hypoglycemia is approximately 1.7-fold higher for T2DM (€91.7 million) than for T1DM (€53 million). The cost of a hypoglycemic episode ranges from €4.59 for a non-severe event where additional self-monitoring of blood glucose (SMBG) testing is the only cost incurred, to €5790.59 for a severe event that also requires an ambulance, A&E, hospitalization, and a visit to a diabetes specialist. A reduction in hypoglycemia event rates could result in substantial cost savings; for example, a 20% reduction in severe and non-severe hypoglycemia rates could result in a saving of €47,769 per general population of 100,000 people.ConclusionsThe LIHT highlights the substantial economic burden of insulin-related hypoglycemia in Italy, particularly with regards to non-severe hypoglycemia, an aspect of hypoglycemia that is often overlooked. This analysis may aid healthcare decision-making by allowing the costs of insulin therapies or diabetes self-management programs to be balanced with the savings provided by reductions in hypoglycemia.FundingNovo Nordisk, UK.Electronic supplementary materialThe online version of this article (10.1007/s13300-018-0418-0) contains supplementary material, which is available to authorized users.

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The economic impact of insulin-related hypoglycemia in Denmark: an analysis using the Local Impact of Hypoglycemia Tool

Cited by 8 publications

References 22 publications

The Economic Burden of Insulin-Related Hypoglycemia in Spain

The Economic Burden of Insulin-Related Hypoglycemia in Spain

Direct medical costs in the preceding, event and subsequent years of a first severe hypoglycaemia episode requiring hospitalization: A population‐based cohort study

The Economic Burden of Insulin-Related Hypoglycemia in Adults with Diabetes: An Analysis from the Perspective of the Italian Healthcare System

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