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Boye KS, Bae JP, Thieu VT, Lage MJ. An Economic Evaluation of the Relationship Between Glycemic Control and Total Healthcare Costs for Adults with Type 2 Diabetes: Retrospective Cohort Study. Diabetes Ther 2024; 15:395-407. [PMID: 38038897 PMCID: PMC10838884 DOI: 10.1007/s13300-023-01507-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/31/2023] [Indexed: 12/02/2023] Open
Abstract
INTRODUCTION Glycemic control is associated with better outcomes among individuals with type 2 diabetes (T2D). This research examines total US all-cause medical costs for adults with T2D with recommended glycemic control (HbA1c < 7%) compared to poor glycemic control (HbA1c ≥ 7%). METHODS The study used administrative claims data linked to HbA1c laboratory test results from January 1, 2015 through June 30, 2021 to identify adults with T2D with a recorded HbA1c test. Patients with recommended glycemic control at index date were propensity score matched to patients with poor glycemic control. General linear models and two-part models were used to compare all-cause outpatient, drug, acute care and total costs for 1 year post index date. RESULTS The study included 59,830 propensity-matched individuals. Results indicate that recommended glycemic control, compared to poor glycemic control, was associated with statistically significantly lower all-cause acute care ($23,868 ± $21,776 vs. $24,352 ± $22,223), drug ($10,277 ± $14,671 vs. $10,540 ± $14,928), and total medical costs ($41,381 ± $42,757 vs. $42,054 ± $43,422) but significantly higher outpatient costs ($7290 ± $12,028 vs. $7026 ± $11,587) (all p < 0.0001). Sensitivity analyses examined results based upon alternative HbA1c thresholds of ≤ 6.5% and < 8%. Results were generally robust to alternative HbA1c thresholds, with higher HbA1c thresholds associated with higher all-cause total costs as well as increased savings for having HbA1c below threshold. CONCLUSIONS Glycemic control was associated with significantly lower all-cause total, drug, and acute care medical costs. Given the high prevalence of T2D in the USA, our results suggest potential economic benefits associated with glycemic control for healthcare providers.
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Affiliation(s)
- Kristina S Boye
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, 46225, USA
| | - Jay P Bae
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, 46225, USA
| | - Vivian T Thieu
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, 46225, USA
| | - Maureen J Lage
- HealthMetrics Outcomes Research, 28 Riverside Lane, Madison, CT, 06443, USA.
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Jalilian H, Heydari S, Imani A, Salimi M, Mir N, Najafipour F. Economic burden of type 2 diabetes in Iran: A cost-of-illness study. Health Sci Rep 2023; 6:e1120. [PMID: 36824619 PMCID: PMC9941092 DOI: 10.1002/hsr2.1120] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 02/23/2023] Open
Abstract
Background and Aims Type 2 diabetes mellitus (T2DM) is a prevalent public health problem worldwide, and the economic burden of the disease poses one of the main challenges for health systems in low- and middle-income countries. This study aimed to estimate the economic burden of T2DM in Iran, in 2018. Methods This was a cost-of-illness study. Three hundred and seventy-five patients with T2DM who were referred to Imam Reza and Sina's educational and therapeutic centers and Asad Abadi clinic in Tabriz, Iran, in 2018 were included. A researcher-constructed checklist was used for data collection. Data were analyzed using EXCEL and SPSS software version 22. Results Total economic burden of diabetes was estimated at 152,443,862,480.3 (purchasing power parity [PPP], Current International $) (approximately 7.69% of GDP, PPP, Current International $). The mean total direct and indirect costs were 11,278.68 (PPP) (62.35% of mean total cost) and 6808.88 (PPP, Current International $) (37.64% of the total cost), respectively. The mean total direct medical cost and the direct nonmedical cost were 10,819.43 (PPP, Current International $) (59.81% of mean total cost) and 459.24 (PPP, Current International $) (2.53% of mean total cost) per patient, respectively. Besides, the mean direct medical cost was 6.18 times the total per capita expenditure on health, and the total direct medical cost was 8.9% times the total expenditure on health. Conclusion Diabetes imposes a substantial economic burden on patients, health systems, and the whole economy. Besides, since the cost of the disease in patients treated with insulin and those with diabetes complications is significantly higher, the reinforcement of self-care measures and focusing on modifying lifestyle (dietary modification and physical activity) in patients with T2DM can significantly reduce the costs of the disease.
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Affiliation(s)
- Habib Jalilian
- Department of Health Services Management, School of HealthAhvaz Jundishapur University of Medical SciencesAhvazIran,Endocrine Research CenterTabriz University of Medical SciencesTabrizIran
| | - Somayeh Heydari
- Endocrine Research CenterTabriz University of Medical SciencesTabrizIran
| | - Ali Imani
- Endocrine Research CenterTabriz University of Medical SciencesTabrizIran,Health Economics Department, Tabriz Health Service Management Research CenterTabriz University of Medical SciencesTabrizIran
| | - Mozhgan Salimi
- Endocrine Research CenterTabriz University of Medical SciencesTabrizIran
| | - Nazanin Mir
- Health Management and Economics Research CenterIran University of Medical SciencesTehranIran
| | - Farzad Najafipour
- Endocrine Research CenterTabriz University of Medical SciencesTabrizIran
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Espinoza MA, Abbott T, Passi A, Balmaceda C. Health and economic effects on patients with type 2 diabetes mellitus in the long run: predictions for the Chilean population. Diabetol Metab Syndr 2022; 14:155. [PMID: 36289521 PMCID: PMC9598003 DOI: 10.1186/s13098-022-00928-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 10/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diabetes is associated to a high financial and disease burden, explaining a large proportion of expenditure of the health system in one year. The purpose of this study was to estimate long-term costs and health outcomes of recently diagnosed patients with type 2 diabetes in Chile. METHODS Cost and consequence study based on mathematical discrete event simulation (DES) model. We modelled expected costs (USD) and quality-adjusted life-years (QALYs) from diagnosis to death (or the age of 95) of a hypothetical cohort of 100,000 incident cases, simulated based on the Chilean National Health Survey 2018. The incidence of twelve complications was estimated assuming the hazard functions provided by the United Kingdom Prospective Diabetes Study. We explore heterogeneity across patients based on their baseline risk covariates and their impact on costs and QALYs. RESULTS The expected cost and QALY of a recently diagnosed type 2 diabetes patient in Chile were USD 8660 and 12.44 QALYs. Both costs and QALYs were independently determined by baseline risk and the patient's life expectancy from the diagnosis. Length of life since diagnosis showed the major impact on costs (5.2% increase for every additional year). Myocardial infarction was the most frequent complication (47.4%) and the most frequent cause of death. CONCLUSION Diabetes type 2 determines a significant expenditure of the health system and substantial health losses. Although the control of cardiovascular risk factors and the metabolic control of the disease, both have an important impact on costs and outcomes, the main impact is achieved by postponing the age of onset of the disease.
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Affiliation(s)
- Manuel Antonio Espinoza
- Departamento de Salud Pública, Unidad de Evaluación de Tecnologías Sanitarias, Pontificia Universidad Católica de Chile, Diagonal Paraguay, Piso 2, 362 Santiago, Chile
| | - Tomas Abbott
- Departamento de Salud Pública, Unidad de Evaluación de Tecnologías Sanitarias, Pontificia Universidad Católica de Chile, Diagonal Paraguay, Piso 2, 362 Santiago, Chile
| | - Alvaro Passi
- Departamento de Salud Pública, Unidad de Evaluación de Tecnologías Sanitarias, Pontificia Universidad Católica de Chile, Diagonal Paraguay, Piso 2, 362 Santiago, Chile
| | - Carlos Balmaceda
- Departamento de Salud Pública, Unidad de Evaluación de Tecnologías Sanitarias, Pontificia Universidad Católica de Chile, Diagonal Paraguay, Piso 2, 362 Santiago, Chile
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Boye KS, Lage MJ, Thieu VT. The Association Between HbA1c and 1-Year Diabetes-Related Medical Costs: A Retrospective Claims Database Analysis. Diabetes Ther 2022; 13:367-377. [PMID: 35129822 PMCID: PMC8873294 DOI: 10.1007/s13300-022-01212-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 01/25/2022] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION The American Diabetes Association (ADA) has identified a target hemoglobin A1c (HbA1c) < 7% as appropriate for most adults with type 2 diabetes (T2D). This research examines US diabetes-related healthcare costs for adults with T2D for individuals with glycemic control (HbA1c < 7%) compared to poor glycemic control (HbA1c ≥ 7%). METHODS The Optum Clinformatics® Data Mart database from 2016 to 2020 was used to identify a cohort of adults with T2D who had a recorded HbA1c test (with first such date identified as the index date) and continuous insurance from 1 year prior through 1 year post index date. Patients with glycemic control were propensity matched to patients with poor glycemic control. Generalized linear models and two-part models examined diabetes-related outpatient, drug, acute care, and total costs over the 1-year post-period. RESULTS There were 34,538 propensity matched individuals included in the study. Results indicate that glycemic control (HbA1c < 7%), compared to poor glycemic control (HbA1c ≥ 7%) ,was associated with statistically significantly lower annual diabetes-related acute ($5671 ± $4216 vs $6138 ± $4211), outpatient ($6051 ± $4216 vs $7259 ± $7771), drug ($3739 ± $4581 vs $4288 ± $4788), and total costs care ($13,704 ± $10,635 vs $16,460 ± $10,885) (all P < 0.0001). Sensitivity analyses also examined results based upon alternative HbA1c thresholds which were chosen on the basis of expert guidelines and prior clinical trial thresholds (< 6%, ≤ 6.5%, < 8%, and ≤ 9%). In all cases, being below threshold was associated with statistically significantly lower diabetes-related total costs and component costs. Results also illustrate that, in general, higher HbA1c thresholds are associated with higher diabetes-related costs. CONCLUSION Glycemic control was found to be associated with significantly lower annual diabetes-related component and total costs. Results suggest economic benefits associated with having HbA1c at or below target.
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Affiliation(s)
- Kristina S. Boye
- Eli Lilly and Company, 893 Delaware Street, Indianapolis, IN 46225 USA
| | - Maureen J. Lage
- HealthMetrics Outcomes Research, 17 Benton’s Knoll, Guilford, CT 06437 USA
| | - Vivian T. Thieu
- Eli Lilly and Company, 893 Delaware Street, Indianapolis, IN 46225 USA
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Rosa LDS, Mistro S, Oliveira MG, Kochergin CN, Cortes ML, de Medeiros DS, Soares DA, Louzado JA, Silva KO, Bezerra VM, Amorim WW, Barone M, Passos LC. Cost-Effectiveness of Point-of-Care A1C Tests in a Primary Care Setting. Front Pharmacol 2021; 11:588309. [PMID: 33542687 PMCID: PMC7851089 DOI: 10.3389/fphar.2020.588309] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 11/23/2020] [Indexed: 12/18/2022] Open
Abstract
Objective: We evaluated the cost-effectiveness of the point-of-care A1c (POC-A1c) test device vs. the traditional laboratory dosage in a primary care setting for people living with type 2 diabetes. Materials and Methods: The Markov model with a 10-year time horizon was based on data from the HealthRise project, in which a group of interventions was implemented to improve diabetes and hypertension control in the primary care network of the urban area of a Brazilian municipality. A POC-A1c device was provided to be used directly in a primary care unit, and for a period of 18 months, 288 patients were included in the point-of-care group, and 1,102 were included in the comparison group. Sensitivity analysis was performed via Monte Carlo simulation and tornado diagram. Results: The results indicated that the POC-A1c device used in the primary care unit was a cost-effective alternative, which improved access to A1c tests and resulted in an increased rate of early control of blood glucose. In the 10-year period, POC-A1c group presented a mean cost of US$10,503.48 per patient and an effectiveness of 0.35 vs. US$9,992.35 and 0.09 for the traditional laboratory test, respectively. The incremental cost was US$511.13 and the incremental effectiveness was 0.26, resulting in an incremental cost-effectiveness ratio of 1,947.10. In Monte Carlo simulation, costs and effectiveness ranged between $9,663.20-$10,683.53 and 0.33-0.37 for POC-A1c test group, and $9,288.28-$10,413.99 and 0.08-0.10 for traditional laboratory test group, at 2.5 and 97.5 percentiles. The costs for nephropathy, retinopathy, and cardiovascular disease and the probability of being hospitalized due to diabetes presented the greatest impact on the model's result. Conclusion: This study showed that using POC-A1c devices in primary care settings is a cost-effective alternative for monitoring glycated hemoglobin A1c as a marker of blood glucose control in people living with type 2 diabetes. According to our model, the use of POC-A1c device in a healthcare unit increased the early control of type 2 diabetes and, consequently, reduced the costs of diabetes-related outcomes, in comparison with a centralized laboratory test.
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Affiliation(s)
- Lorena de Sousa Rosa
- Program of Post-Graduation in Medicine and Health, Federal University of Bahia, Salvador, Brazil
| | - Sóstenes Mistro
- Program of Post-Graduation in Collective Health, Multidisciplinary Institute of Health, Federal University of Bahia, Vitória da Conquista, Brazil
| | - Marcio Galvão Oliveira
- Program of Post-Graduation in Collective Health, Multidisciplinary Institute of Health, Federal University of Bahia, Vitória da Conquista, Brazil
| | | | - Mateus Lopes Cortes
- Multidisciplinary Institute of Health, Federal University of Bahia, Vitória da Conquista, Brazil
| | - Danielle Souto de Medeiros
- Program of Post-Graduation in Collective Health, Multidisciplinary Institute of Health, Federal University of Bahia, Vitória da Conquista, Brazil
| | - Daniela Arruda Soares
- Program of Post-Graduation in Collective Health, Multidisciplinary Institute of Health, Federal University of Bahia, Vitória da Conquista, Brazil
| | - José Andrade Louzado
- Multidisciplinary Institute of Health, Federal University of Bahia, Vitória da Conquista, Brazil
| | - Kelle Oliveira Silva
- Multidisciplinary Institute of Health, Federal University of Bahia, Vitória da Conquista, Brazil
| | - Vanessa Moraes Bezerra
- Program of Post-Graduation in Collective Health, Multidisciplinary Institute of Health, Federal University of Bahia, Vitória da Conquista, Brazil
| | - Welma Wildes Amorim
- Departament of Natural Sciences, State University of Southwest Bahia, Vitória da Conquista, Brazil
| | - Mark Barone
- Intersectoral Forum to Fight NCDs in Brazil, São Paulo, Brazil
| | - Luiz Carlos Passos
- Program of Post-Graduation in Medicine and Health, Federal University of Bahia, Salvador, Brazil
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Alzaid A, Ladrón de Guevara P, Beillat M, Lehner Martin V, Atanasov P. Burden of disease and costs associated with type 2 diabetes in emerging and established markets: systematic review analyses. Expert Rev Pharmacoecon Outcomes Res 2020; 21:785-798. [PMID: 32686530 DOI: 10.1080/14737167.2020.1782748] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Objectives: To estimate the clinical and economic burden of type 2 diabetes (T2D) in established (EST) and emerging markets (EMG).Methods: Three systematic literature reviews were conducted in MEDLINE and Embase to capture all relevant publications reporting 1) the epidemiology of T2D and complications in T2D and 2) the economic burden of T2D and associated complications.Results: In total, 294 studies were included in this analysis. Evidence indicates a high and increasing overall prevalence of T2D globally, ranging up to 23% in EMG markets and 14% in EST markets. Undiagnosed cases were higher in EMG versus EST markets (up to 67% vs 38%), potentially due to a lack of education and disease awareness in certain regions, that could lead to important clinical and economic consequences. Poor glycemic control was associated with the development of several complications (e.g. retinopathy, cardiovascular diseases and nephropathy) that increase the risk of morbidity and mortality. Direct costs were up to 9-fold higher in patients with vs without T2D-related complications.Conclusions: The burden of T2D, related complications and inherent costs are higher in emerging versus established market countries. This review explores potential strategies to reduce costs and enhance outcomes of T2D treatment in developing countries.
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Affiliation(s)
- Aus Alzaid
- Consultant Diabetologist, Riyadh, Saudi Arabia
| | - Patricia Ladrón de Guevara
- Health Economics & Market Access, Health Economics and Market Access, Amaris Consulting, Barcelona, Spain
| | - Maud Beillat
- Global Market Access, Health Economics & Outcomes Research, Servier Global Market Access & HEOR, France
| | | | - Petar Atanasov
- Health Economics & Market Access, Health Economics and Market Access, Amaris Consulting, Barcelona, Spain
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García-Molina L, Lewis-Mikhael AM, Riquelme-Gallego B, Cano-Ibáñez N, Oliveras-López MJ, Bueno-Cavanillas A. Improving type 2 diabetes mellitus glycaemic control through lifestyle modification implementing diet intervention: a systematic review and meta-analysis. Eur J Nutr 2019; 59:1313-1328. [PMID: 31781857 DOI: 10.1007/s00394-019-02147-6] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 11/18/2019] [Indexed: 12/12/2022]
Abstract
PURPOSE Type 2 diabetes mellitus represents a significant health problem. Many studies have reported that intensive nutritional intervention by itself or in addition to medications is the best method to improve glycaemic control in type 2 diabetes mellitus. However, in clinical practice, dietary education is not implemented as an integral part in the management of type 2 diabetes mellitus. The purpose of this systematic review and meta-analysis is to analyse the scientific evidence concerning the role of nutritional intervention in the glycaemic control of type 2 diabetes mellitus. METHODS We searched Pubmed, Scopus, Cochrane Library and Web of Science databases from inception till May 2019 for randomised controlled trials (RCTs) that include dietary interventions in the management of patients with type 2 diabetes mellitus. RESULTS A total of 28 studies were included. Our results demonstrated that lifestyle interventions significantly lowered glycosylated haemoglobin (HbA1c) levels compared to the usual care for patients with type 2 diabetes mellitus, overall weighted mean difference, WMD = - 0.51 (- 0.67, - 0.35). Strategies combining individualized and group-based activities were the most effective, WMD = - 0.95 (- 1.24, - 0.66). Most of stratified analyses did not totally resolve heterogeneity, but improvement in HbA1c levels has been consistently observed. CONCLUSIONS The available evidence from RCTs shows that lifestyle intervention is more effective than the standard care regarding the glycaemic control of type 2 diabetic patients, particularly when there is a weight loss. It is time to translate this evidence to the primary health care practice. The protocol of the present systematic review was registered in PROSPERO, registration number CRD42018090469.
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Affiliation(s)
- Laura García-Molina
- Department of Preventive Medicine and Public Health, University of Granada, Avenida de la Investigación, 11, 18016, Granada, Spain.
- CIBER Epidemiología y Salud Pública (CIBERESP), Avenida Monforte de Lemos, 3-5, 28029, Madrid, Spain.
| | - Anne-Mary Lewis-Mikhael
- Department of Obstetrics and Gynecology, McMaster University, 1280 Main Street West, Hamilton, ON, Canada
- High Institute of Pubic Health, Alexandria University, 165 El-Horreya Avenue - El-Ibrahimia, Alexandria, Egypt
| | - Blanca Riquelme-Gallego
- Department of Preventive Medicine and Public Health, University of Granada, Avenida de la Investigación, 11, 18016, Granada, Spain
- Fundación para la Investigación Biosanitaria de Andalucía Oriental (FIBAO), Avenida de Madrid, 15, 18018, Granada, Spain
| | - Naomi Cano-Ibáñez
- Department of Preventive Medicine and Public Health, University of Granada, Avenida de la Investigación, 11, 18016, Granada, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Avenida Monforte de Lemos, 3-5, 28029, Madrid, Spain
| | - María-Jesús Oliveras-López
- Department of Molecular Biology and Biochemical Engineering, University Pablo de Olavide, Carretera de Utrera, Km 1, 41013, Seville, Spain
| | - Aurora Bueno-Cavanillas
- Department of Preventive Medicine and Public Health, University of Granada, Avenida de la Investigación, 11, 18016, Granada, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Avenida Monforte de Lemos, 3-5, 28029, Madrid, Spain
- Instituto de Investigación Biosanitaria de Granada (ibs.Granada), Servicio Andaluz de Salud/Universidad de Granada, Avenida de Madrid, 15, 18018, Granada, Spain
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Shah S, Abbas G, Hanif M, Anees-Ur-Rehman, Zaman M, Riaz N, Altaf A, Hassan SU, Saleem U, Shah A. Increased burden of disease and role of health economics: Asia-pacific region. Expert Rev Pharmacoecon Outcomes Res 2019; 19:517-528. [DOI: 10.1080/14737167.2019.1650643] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Shahid Shah
- Faculty of Pharmaceutical Sciences, Government College University, Faisalabad, Pakistan
| | - Ghulam Abbas
- Faculty of Pharmaceutical Sciences, Government College University, Faisalabad, Pakistan
| | - Muhammad Hanif
- Department of Pharmaceutics, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
| | - Anees-Ur-Rehman
- Department of Clinical Pharmacy, School of Pharmaceutical Sciences, University Sains Penang, Malaysia
| | - Muhammad Zaman
- Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan
| | - Nabeel Riaz
- Faculty of Pharmaceutical Sciences, Government College University, Faisalabad, Pakistan
| | - Arslan Altaf
- Faculty of Pharmaceutical Sciences, Government College University, Faisalabad, Pakistan
| | - Shams Ul Hassan
- Faculty of Pharmaceutical Sciences, Government College University, Faisalabad, Pakistan
| | - Usman Saleem
- Faculty of Pharmaceutical Sciences, Government College University, Faisalabad, Pakistan
| | - Abid Shah
- Pediatric Medicine Department, Mukhtar Ahmad Sheikh Hospital, Multan, Pakistan
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Wu H, Eggleston KN, Zhong J, Hu R, Wang C, Xie K, Chen Y, Chen X, Yu M. Direct medical cost of diabetes in rural China using electronic insurance claims data and diabetes management data. J Diabetes Investig 2019; 10:531-538. [PMID: 29993198 PMCID: PMC6400160 DOI: 10.1111/jdi.12897] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 06/12/2018] [Accepted: 07/09/2018] [Indexed: 11/29/2022] Open
Abstract
AIMS/INTRODUCTION To evaluate the annual direct medical cost attributable to type 2 diabetes mellitus according to socioeconomic factors, medical conditions and complications categories. MATERIALS AND METHODS We created uniquely detailed data from merging datasets of the local diabetes management system and the social security system in Tongxiang, China. We calculated the type 2 diabetes mellitus-related total cost and out-of-pocket cost for inpatient admissions and outpatient visits, and compared the cost for patients with or without complications by different healthcare items. RESULTS A total of 16,675 patients were eligible for analysis. The type 2 diabetes mellitus-related cost accounted for 40.6% of the overall cost. The cost per patient was estimated to be a median of 1,067 Chinese Yuan, 7,114 Chinese Yuan and 969 Chinese Yuan for inpatient and outpatient cost, respectively. The median total cost for hospital-based care was 3.69-fold higher than that for primary care. The median cost of patients with complications was 3.46-fold higher than that of those without complications. The median cost for a patient with only macrovascular, only microvascular or both macrovascular and microvascular complications were 3.13-, 3.79- and 10.95-fold higher than that of patients without complications. Pharmaceutical expenditure accounted for 51.8 and 79.7% of the total cost for patients with or without complications, respectively. CONCLUSIONS Although the type 2 diabetes mellitus-related cost per patient was relatively low, it accounted for a great proportion of the overall cost. Complications obviously aggravated the economic burden of type 2 diabetes mellitus. Proper management and the prevention of diabetes and its complications are urgently required to curtail the economic burden.
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Affiliation(s)
- Haibin Wu
- Department of NCDs Control and PreventionZhejiang Provincial Center for Disease Control and PreventionHangzhouChina
| | - Karen N Eggleston
- Shorenstein Asia‐Pacific Research CenterStanford UniversityStanfordCaliforniaUSA
| | - Jieming Zhong
- Department of NCDs Control and PreventionZhejiang Provincial Center for Disease Control and PreventionHangzhouChina
| | - Ruying Hu
- Department of NCDs Control and PreventionZhejiang Provincial Center for Disease Control and PreventionHangzhouChina
| | - Chunmei Wang
- Tongxiang Center for Disease Control and PreventionTongxiangChina
| | - Kaixu Xie
- Tongxiang Center for Disease Control and PreventionTongxiangChina
| | - Yiwei Chen
- Stanford UniversityStanfordCaliforniaUSA
| | - Xiangyu Chen
- Department of NCDs Control and PreventionZhejiang Provincial Center for Disease Control and PreventionHangzhouChina
| | - Min Yu
- Department of NCDs Control and PreventionZhejiang Provincial Center for Disease Control and PreventionHangzhouChina
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