Janssen Inc., Toronto, Ontario, Canada.
IQVIA, Kirkland, Quebec, Canada.
Diabetes Obes Metab. 2021 Apr;23(4):916-928. doi: 10.1111/dom.14294. Epub 2021 Jan 13.
To better understand the healthcare burden of people with type 2 diabetes (T2D) and estimated glomerular filtration rate (eGFR) < 90 mL/min/1.73 m in Ontario, Canada.
We used administrative data to evaluate the prevalence of T2D, eGFR < 90 mL/min/1.73 m and adverse cardiovascular co-morbidities in individuals aged ≥ 30 years living in Ontario, Canada. We also examined incremental healthcare costs and healthcare resource utilization (HCRU) for these patients with specific incident cardiovascular and renal outcomes, in comparison with controls without these outcomes.
While the prevalence of T2D in the general population aged ≥ 30 years in Ontario increased by 1.8% over a 5-year period (2011-2012 to 2015-2016), the prevalence of eGFR < 90 mL/min/1.73 m among people with T2D increased by 35%. In comparison with corresponding controls without these outcomes, the per patient average total costs (Canadian dollars) over a 2-year analysis period were higher for patients with cardiovascular disease/chronic kidney disease related death ($69 827; n = 32 407), doubling of serum creatinine ($52 260; n = 22 825), those who started dialysis ($150 627; n = 3499) or received a kidney transplant ($50 664; n = 651). Similarly, HCRU was significantly greater for patients with these incident outcomes.
This real-world retrospective study highlights an increasing prevalence of T2D, eGFR < 90 mL/min/1.73 m , and the substantially higher healthcare costs and HCRU when these patients have adverse cardiovascular and renal outcomes. The existence of such a large economic burden underpins the importance of preventing these diabetes-related complications.
更好地了解加拿大安大略省患有 2 型糖尿病(T2D)和估计肾小球滤过率(eGFR)<90mL/min/1.73m 的人群的医疗保健负担。
我们使用行政数据评估了年龄≥30 岁的安大略省居民中 T2D、eGFR<90mL/min/1.73m 和不良心血管合并症的患病率。我们还比较了具有特定心血管和肾脏结局的患者与没有这些结局的患者的增量医疗成本和医疗资源利用(HCRU)。
尽管安大略省≥30 岁的一般人群中 T2D 的患病率在 5 年内增加了 1.8%(2011-2012 年至 2015-2016 年),但 T2D 患者的 eGFR<90mL/min/1.73m 患病率却增加了 35%。与没有这些结局的相应对照者相比,在 2 年分析期间,每位患者的平均总费用(加元)对于患有心血管疾病/慢性肾脏病相关死亡的患者(32407 例,69827 美元)、血清肌酐翻倍(22825 例,52260 美元)、开始透析的患者(3499 例,150627 美元)或接受肾脏移植的患者(651 例,50664 美元)更高。同样,这些患者发生这些事件的 HCRU 也明显更高。
这项真实世界的回顾性研究强调了 T2D、eGFR<90mL/min/1.73m 的患病率不断增加,以及当这些患者发生不良心血管和肾脏结局时,医疗保健成本和 HCRU 显著增加。这种巨大的经济负担的存在突显了预防这些糖尿病相关并发症的重要性。