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Use of healthcare resources and costs associated to the start of treatment with injectable drugs in patients with type 2 diabetes mellitus.
Endocrinol Nutr. 2016 Dec; 63(10):527-535.EN

Abstract

OBJECTIVES

The main objective was to assess resource use and costs of starting treatment with insulin or injectable GLP-1 receptor analogues (GLP-1 RAs) in a Spanish population of patients with type 2 diabetes mellitus. Treatment adherence and persistence were also determined for both treatment groups.

PATIENTS AND METHODS

A retrospective, non-interventional, observational study was conducted. Patients aged ≥20 years who started treatment with insulin or GLP-1 RAs in the 2010-2012 period were recruited. Use of healthcare resources was estimated to evaluate healthcare costs in these two groups of patients (medical visits, hospital stay, emergency visits, diagnostic or treatment requests, medication). Clinical information including body mass index (BMI, kg/m2), metabolic control (HbA1c), adherence, persistence, and complications (hypoglycemia, and cardiovascular events (CVE) was collected. The follow-up period was 12 months. Only direct healthcare costs were considered.

RESULTS

A total of 1301 patients with a mean age of 67.6 years (51.6% males) were recruited. Of these, 71.9% and 28.1% were on treatment with insulin and GLP-1 RA respectively. After one year of follow-up, patients treated with GLP-1 RAs were found less visits to primary care (8 vs. 11; P<.001) and specialized care (1.0 vs. 1.8; P<.001), hospital stays (0.3 vs. 0.7; P=.030) and less visits to the emergency room (0.8 vs. 1.6; P<.001). Patients treated with GLP-1 showed greater adherence (88.1% vs. 82.7%; P<.001) and persistence (62.0% vs. 55.9%; P=.046), and had less hypoglycemia episodes (13.4% vs. 18.7%; P=.022), with similar metabolic control (HbA1c: 7.2% vs. 7.4%; P=.049), BMI (29.1 vs. 30.9kg/m2), and CVE rate (9.1% vs. 11.5%; P=.330) respectively. The mean corrected direct healthcare cost per patient was €1787 vs. €2005 (P=.046.) CONCLUSIONS: Patients treated with GLP-1 RAs caused lower direct healthcare costs for the National Health System than patients treated with insulin. The results may be explained by greater treatment adherence and lower hypoglycemia rates in patients treated with GLP-1 RAs. Additional studies are needed to confirm these possibilities.

Authors+Show Affiliations

Dirección de Planificación, Badalona Serveis Assistencials SA, Badalona, Barcelona, España.Documentación Médica, Hospital Germans Trias i Pujol, Badalona, Barcelona, España.Departamento de Evaluación de Medicamentos, GlaxoSmithKline, Madrid, España. Electronic address: raul.l.morano-larragueta@gsk.com.Departamento de Evaluación de Medicamentos, GlaxoSmithKline, Madrid, España.

Pub Type(s)

Journal Article
Multicenter Study
Observational Study

Language

eng spa

PubMed ID

27744013

Citation

Sicras-Mainar, Antoni, et al. "Use of Healthcare Resources and Costs Associated to the Start of Treatment With Injectable Drugs in Patients With Type 2 Diabetes Mellitus." Endocrinologia Y Nutricion : Organo De La Sociedad Espanola De Endocrinologia Y Nutricion, vol. 63, no. 10, 2016, pp. 527-535.
Sicras-Mainar A, Navarro-Artieda R, Morano R, et al. Use of healthcare resources and costs associated to the start of treatment with injectable drugs in patients with type 2 diabetes mellitus. Endocrinol Nutr. 2016;63(10):527-535.
Sicras-Mainar, A., Navarro-Artieda, R., Morano, R., & Ruíz, L. (2016). Use of healthcare resources and costs associated to the start of treatment with injectable drugs in patients with type 2 diabetes mellitus. Endocrinologia Y Nutricion : Organo De La Sociedad Espanola De Endocrinologia Y Nutricion, 63(10), 527-535. https://doi.org/10.1016/j.endonu.2016.07.001
Sicras-Mainar A, et al. Use of Healthcare Resources and Costs Associated to the Start of Treatment With Injectable Drugs in Patients With Type 2 Diabetes Mellitus. Endocrinol Nutr. 2016;63(10):527-535. PubMed PMID: 27744013.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of healthcare resources and costs associated to the start of treatment with injectable drugs in patients with type 2 diabetes mellitus. AU - Sicras-Mainar,Antoni, AU - Navarro-Artieda,Ruth, AU - Morano,Raúl, AU - Ruíz,Lucía, Y1 - 2016/10/13/ PY - 2016/02/15/received PY - 2016/06/30/revised PY - 2016/07/04/accepted PY - 2016/10/17/pubmed PY - 2017/11/29/medline PY - 2016/10/17/entrez KW - Adherence KW - Adherencia KW - Consumo de recursos sanitarios KW - Costes sanitarios KW - Diabetes tipo 2 KW - Healthcare costs KW - Healthcare resource utilization KW - Hipoglucemias KW - Hypoglycemia KW - Persistence KW - Persistencia KW - Type 2 diabetes SP - 527 EP - 535 JF - Endocrinologia y nutricion : organo de la Sociedad Espanola de Endocrinologia y Nutricion JO - Endocrinol Nutr VL - 63 IS - 10 N2 - OBJECTIVES: The main objective was to assess resource use and costs of starting treatment with insulin or injectable GLP-1 receptor analogues (GLP-1 RAs) in a Spanish population of patients with type 2 diabetes mellitus. Treatment adherence and persistence were also determined for both treatment groups. PATIENTS AND METHODS: A retrospective, non-interventional, observational study was conducted. Patients aged ≥20 years who started treatment with insulin or GLP-1 RAs in the 2010-2012 period were recruited. Use of healthcare resources was estimated to evaluate healthcare costs in these two groups of patients (medical visits, hospital stay, emergency visits, diagnostic or treatment requests, medication). Clinical information including body mass index (BMI, kg/m2), metabolic control (HbA1c), adherence, persistence, and complications (hypoglycemia, and cardiovascular events (CVE) was collected. The follow-up period was 12 months. Only direct healthcare costs were considered. RESULTS: A total of 1301 patients with a mean age of 67.6 years (51.6% males) were recruited. Of these, 71.9% and 28.1% were on treatment with insulin and GLP-1 RA respectively. After one year of follow-up, patients treated with GLP-1 RAs were found less visits to primary care (8 vs. 11; P<.001) and specialized care (1.0 vs. 1.8; P<.001), hospital stays (0.3 vs. 0.7; P=.030) and less visits to the emergency room (0.8 vs. 1.6; P<.001). Patients treated with GLP-1 showed greater adherence (88.1% vs. 82.7%; P<.001) and persistence (62.0% vs. 55.9%; P=.046), and had less hypoglycemia episodes (13.4% vs. 18.7%; P=.022), with similar metabolic control (HbA1c: 7.2% vs. 7.4%; P=.049), BMI (29.1 vs. 30.9kg/m2), and CVE rate (9.1% vs. 11.5%; P=.330) respectively. The mean corrected direct healthcare cost per patient was €1787 vs. €2005 (P=.046.) CONCLUSIONS: Patients treated with GLP-1 RAs caused lower direct healthcare costs for the National Health System than patients treated with insulin. The results may be explained by greater treatment adherence and lower hypoglycemia rates in patients treated with GLP-1 RAs. Additional studies are needed to confirm these possibilities. SN - 1579-2021 UR - https://www.unboundmedicine.com/medline/citation/27744013/Use_of_healthcare_resources_and_costs_associated_to_the_start_of_treatment_with_injectable_drugs_in_patients_with_type_2_diabetes_mellitus_ L2 - http://linkinghub.elsevier.com/retrieve/pii/S1575-0922(16)30106-1 DB - PRIME DP - Unbound Medicine ER -