Healthcare Costs of Diabetes and Microvascular and Macrovascular Disease in Individuals with Incident Type 2 Diabetes Mellitus: A Ten-Year Longitudinal Study

• Published in: ClinicoEconomics and outcomes research Vol. 12; pp. 423 - 434
• Main Authors: Visaria, Jay, Iyer, Neeraj N, Raval, Amit D, Kong, Sheldon X, Hobbs, Todd, Bouchard, Jonathan, Kern, David M, Willey, Vincent J
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2020; Taylor & Francis Ltd; Dove; Dove Medical Press
• Subjects: Cardiovascular disease; Codes; Costs; Diabetes; diabetes costs; Drug therapy; Economic aspects; Economic models; Health care policy; Health insurance; healthcare costs; Identification; Insulin; Longitudinal studies; macrovascular complications; Medical economics; Medical research; microvascular complications; Online databases; Original Research; Patients; Personal health; Pharmacy; Privacy; Studies; Type 2 diabetes; type 2 diabetes mellitus; Vascular diseases; United States > US; type 2 diabetes mellitus; macrovascular complications; diabetes; healthcare costs; microvascular complications; diabetes costs
• ISSN: 1178-6981; 1178-6981
• DOI: 10.2147/CEOR.S247498

The objective of this study was to estimate the incremental long-term costs associated with T2DM attributable to vascular diseases. This retrospective cohort study identified newly diagnosed (incident) T2DM patients in 2007 (baseline to 01/01/2006) using the HealthCore Integrated Research Database, a repository of nationally representative claims data. Incident T2DM patients were 1:1 exact matched on age, gender and other factors of interest to non-DM patients, and followed until the earlier of 8 follow-up years or death. Patients with documented vascular disease diagnosis were identified during the study period. All-cause and T2DM/vascular disease-related annual healthcare costs were examined for each follow-up year. The study included 13,883 individuals with T2DM and matched non-DM controls. Among individuals with T2DM, 11,792 (85%) had vascular disease versus 9251 (66.6%) non-T2DM between 01/01/2006 and 12/31/2015. Among T2DM patients, mean all-cause annual costs were greater than in non-T2DM patients ($13,806 vs $7,243, baseline, $21,745 vs $8,524, post-index year 1, $12,756-$14,793 vs $8,349-$9,940 years 2-8, p< 0.001), respectively. A similar trend was observed for T2DM/vascular disease-related costs (p< 0. 001). T2DM/vascular disease-related costs were largest during post-index year 1, accounting for the majority of all-cause cost difference between T2DM patients and matched non-DM controls. Incident T2DM individuals without vascular disease at any time had significantly lower costs compared to non-DM controls (p< 0. 001) between years 2-8 of follow-up. Vascular disease increased the cost burden for individuals with T2DM. The cost impact of diabetes and vascular disease was highest in the year after diagnosis, and persisted for at least seven additional years, while the cost of T2DM patients without vascular disease trended lower than for matched non-DM patients. These data highlight potential costs that could be offset by earlier and more effective detection and management of T2DM aimed at reducing vascular disease burden.