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2型糖尿病合并心血管疾病患者使用恩格列净与其他降糖药物的医疗成本和资源利用情况:一项真实世界回顾性队列分析

Healthcare Costs and Resource Utilization Associated with the Use of Empagliflozin Versus Other Antihyperglycemic Agents Among Patients with Type 2 Diabetes Mellitus and Cardiovascular Disease: A Real-World Retrospective Cohort Analysis.

作者信息

Raju Aditya, Pimple Pratik, Stafkey-Mailey Dana, Farrelly Eileen, Shetty Sharash

机构信息

Xcenda LLC, Carrollton, TX, USA.

Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, USA.

出版信息

Diabetes Ther. 2022 Jan;13(1):25-42. doi: 10.1007/s13300-021-01173-0. Epub 2021 Nov 2.

Abstract

INTRODUCTION

Empagliflozin has demonstrated lower rates of cardiovascular outcomes vs. standard of care among patients with type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). However, the impact of empagliflozin compared to other branded antihyperglycemic agents (AHAs) on total cost of care has yet to be quantified.

METHODS AND RESULTS

This retrospective cohort study evaluated the impact of empagliflozin (n = 441) on costs and healthcare resource utilization (HCRU) vs. other branded AHAs (n = 13,122) among patients with T2DM and CVD, using the IQVIA PharMetrics Plus Claims Database (1 August 2013-31 December 2017). Date of the first prescription (index date) for empagliflozin or other branded AHAs was used to classify patients into study cohorts. All-cause costs and HCRU were computed on a per patient per month (PPPM) basis and compared across study cohorts using outcome-appropriate statistical models. Overall, the empagliflozin cohort was younger and had a lower comorbidity burden. After covariate adjustment, the total all-cause costs (mean difference - $412 PPPM; 95% CI - $593, - $214) were significantly lower for the empagliflozin cohort. These cost differences were mainly driven by lower all-cause medical costs (mean difference - $400 PPPM; 95% CI - $577, - $196). For HCRU, the mean adjusted all-cause visits in the physician office and other outpatient settings were lower with empagliflozin vs. other branded AHAs (p < 0.001).

CONCLUSIONS

This study demonstrated that the all-cause healthcare costs and HCRU were significantly lower for patients with T2DM and CVD who initiated empagliflozin vs. other branded AHAs. Along with the positive clinical evidence base of empagliflozin, these results can guide healthcare decision makers during therapy selection.

摘要

简介

在2型糖尿病(T2DM)和心血管疾病(CVD)患者中,与标准治疗相比,恩格列净已显示出较低的心血管事件发生率。然而,与其他品牌的抗高血糖药物(AHA)相比,恩格列净对总护理成本的影响尚未量化。

方法和结果

这项回顾性队列研究使用IQVIA PharMetrics Plus索赔数据库(2013年8月1日至2017年12月31日),评估了恩格列净(n = 441)与其他品牌AHA(n = 13,122)相比对T2DM和CVD患者成本和医疗资源利用(HCRU)的影响。恩格列净或其他品牌AHA的首次处方日期(索引日期)用于将患者分类到研究队列中。全因成本和HCRU按每位患者每月(PPPM)计算,并使用适合结果的统计模型在研究队列之间进行比较。总体而言,恩格列净队列更年轻,合并症负担更低。经过协变量调整后,恩格列净队列的全因总成本(平均差异 - 412美元/PPPM;95%CI - 593, - 214)显著更低。这些成本差异主要由较低的全因医疗成本驱动(平均差异 - 400美元/PPPM;95%CI - 577, - 196)。对于HCRU,与其他品牌AHA相比,恩格列净在医生办公室和其他门诊环境中的平均调整后全因就诊次数更低(p < 0.001)。

结论

这项研究表明,与其他品牌AHA相比,开始使用恩格列净的T2DM和CVD患者的全因医疗成本和HCRU显著更低。连同恩格列净的积极临床证据基础,这些结果可以指导医疗保健决策者进行治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af0c/8776959/58bc3c3cd6a4/13300_2021_1173_Fig1_HTML.jpg

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