Visaria Jay, Iyer Neeraj N, Raval Amit D, Kong Sheldon X, Hobbs Todd, Bouchard Jonathan, Kern David M, Willey Vincent J
HealthCore, Inc., Wilmington, DE, USA.
Novo Nordisk, Inc., Plainsboro Township, NJ, USA.
Clinicoecon Outcomes Res. 2020 Aug 10;12:423-434. doi: 10.2147/CEOR.S247498. eCollection 2020.
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.
本研究的目的是估计2型糖尿病归因于血管疾病的长期增量成本。
这项回顾性队列研究使用HealthCore综合研究数据库（一个具有全国代表性的索赔数据存储库）确定了2007年（基线至2006年1月1日）新诊断（发病）的2型糖尿病患者。将发病的2型糖尿病患者在年龄、性别和其他感兴趣的因素上与非糖尿病患者进行1:1精确匹配，并随访至8年随访期或死亡两者中较早者。在研究期间确定有血管疾病诊断记录的患者。对每个随访年份的全因和2型糖尿病/血管疾病相关的年度医疗保健成本进行了检查。
该研究纳入了13,883名2型糖尿病患者和匹配的非糖尿病对照组。在2型糖尿病患者中，2006年1月1日至2015年12月31日期间，11,792名（85%）患有血管疾病，而非2型糖尿病患者中有9251名（66.6%）患有血管疾病。在2型糖尿病患者中，全因年均成本高于非2型糖尿病患者（基线时分别为13,806美元对7,243美元，索引后第1年为21,745美元对8,524美元，第2 - 8年为12,756 - 14,793美元对8,349 - 9,940美元，p < 0.001）。2型糖尿病/血管疾病相关成本也观察到类似趋势（p < 0.001）。2型糖尿病/血管疾病相关成本在索引后第1年最高，占2型糖尿病患者与匹配的非糖尿病对照组之间全因成本差异的大部分。在随访的第2 - 8年期间，任何时候无血管疾病的发病2型糖尿病个体的成本显著低于非糖尿病对照组（p < 0.001）。
血管疾病增加了2型糖尿病患者的成本负担。糖尿病和血管疾病的成本影响在诊断后的第一年最高，并持续至少另外七年，而无血管疾病的2型糖尿病患者的成本趋势低于匹配的非糖尿病患者。这些数据突出了通过更早、更有效地检测和管理2型糖尿病以减轻血管疾病负担可能抵消的潜在成本。
