Endocrine and Metabolic Associates, Rockville, MD, USA.
Diabetes Res Clin Pract. 2010 Mar;87(3):360-5. doi: 10.1016/j.diabres.2009.11.021. Epub 2010 Jan 4.
The number of prescription medications and out-of-pocket expenses of individuals with type 2 diabetes mellitus (T2DM) were evaluated to assess the economic burden of diabetes.
The self-reported number of prescription medications and out-of-pocket healthcare expenses were evaluated from respondents of the United States SHIELD study with and without a diagnosis of T2DM. Medications included monotherapy and combination therapy; combination tablets were counted as one agent. Analysis of variance and multivariate linear regression models adjusted for age, gender, prescription insurance coverage, and household income.
Of the T2DM respondents (n=3551), 40% were on 1 prescription antidiabetic agent (7% insulin alone), 26% were on 2 agents, 8% were on >or=3 agents, with a mean of 1.3 antidiabetic agents. After adjusting for age, gender, insurance coverage, and income, respondents with T2DM had a significantly larger total number of prescriptions (6.2) and higher out-of-pocket expenses for both annual medical ($1158) and monthly prescription ($144) expenses, compared with respondents without T2DM (n=8686) (4.1 prescriptions, $925 annual medical, $118 monthly prescription) (p<0.01).
Increased out-of-pocket medical and medication costs in T2DM are due to the use of both antidiabetic agents and other medications for treatment of comorbid conditions.
评估 2 型糖尿病（T2DM）患者的处方药数量和自付费用，以评估糖尿病的经济负担。
从美国 SHIELD 研究的有和没有 T2DM 诊断的受访者中评估自我报告的处方药数量和自付医疗保健费用。药物包括单药治疗和联合治疗；联合片剂算作一种药物。使用方差分析和多元线性回归模型调整年龄、性别、处方保险覆盖范围和家庭收入。
在 T2DM 受访者（n=3551）中，40%的人使用 1 种处方降糖药（单独使用 7%的胰岛素），26%的人使用 2 种药物，8%的人使用 >或=3 种药物，平均使用 1.3 种降糖药。在调整年龄、性别、保险覆盖范围和收入后，与没有 T2DM（n=8686）的受访者相比，T2DM 受访者的总处方数量（6.2）和年度医疗（$1158）和每月处方（$144）自付费用显著更高（p<0.01）。
T2DM 中自付医疗和药物费用的增加是由于使用降糖药和其他药物治疗合并症所致。
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