Edwards Michael A, Wall-Wieler Elizabeth, Liu Yuki, Zheng Feibi, Coviello Andrea
Department of Medicine, University of North Carolina.
Global Health Economics and Outcomes Research, Intuitive Surgical.
Ann Surg. 2024 May 22. doi: 10.1097/SLA.0000000000006353.
Determine out-of-pocket (OOP) costs two years after sleeve gastrectomy (SG) or initiating Ozempic for patients with type 2 diabetes (T2D) and obesity.
Individuals with obesity and T2D have a variety of treatment options. Risks and benefits of these treatment options are becoming more well documented; however, the real-world patient costs of these options are not known.
Adults with body mass index (BMI) 35 kg/m2 or higher, and T2D who had an SG or used Ozempic were identified in the employer-based retrospective claims database Merative™ (previously Truven IBM Marketscan) from 2017 to 2021. SG cohort was defined as having a SG (without filling a prescription for Ozempic) and Ozempic cohort was defined as continuously filling a prescription for Ozempic for at least 2 years (and not having any bariatric surgery). Individuals in each cohort were 1:1 propensity matched on demographics, obesity-related comorbidities, and baseline OOP costs. in the year before treatment. OOP costs were compared in the two years after treatment using paired t-tests.
302 SG were matched to 302 Ozempic patients (mean age 50, mean baseline BMI 40, 41% male). OOP healthcare costs were similar for the SG ($2,267) and Ozempic ($2,131) cohorts 1-year after index date (difference=$136, P=0.19). OOP healthcare costs were significantly lower in the SG cohort ($1,155 vs. $2,084, P<0.01) 2-years after index date.
Within 2 years of starting treatment, OOP healthcare costs were significantly lower among individuals who had a SG versus those treated with Ozempic.
确定接受袖状胃切除术(SG)或开始使用奥泽米皮克治疗2型糖尿病(T2D)和肥胖症患者两年后的自付费用。
肥胖症和T2D患者有多种治疗选择。这些治疗选择的风险和益处越来越有充分的文献记载;然而,这些选择在现实世界中的患者成本尚不清楚。
在2017年至2021年基于雇主的回顾性索赔数据库Merative™(以前的Truven IBM Marketscan)中,识别出体重指数(BMI)为35kg/m²或更高且患有T2D并接受了SG或使用了奥泽米皮克的成年人。SG队列定义为接受了SG(未开具奥泽米皮克处方),奥泽米皮克队列定义为连续开具奥泽米皮克处方至少2年(且未进行任何减肥手术)。每个队列中的个体在人口统计学、肥胖相关合并症和治疗前一年的基线自付费用方面进行1:1倾向匹配。使用配对t检验比较治疗后两年的自付费用。
302例接受SG治疗的患者与302例使用奥泽米皮克的患者匹配(平均年龄50岁,平均基线BMI为40,41%为男性)。索引日期后1年,SG队列(2267美元)和奥泽米皮克队列(2131美元)的自付医疗费用相似(差异=136美元,P=0.19)。索引日期后2年,SG队列的自付医疗费用显著更低(1155美元对2084美元,P<0.01)。
在开始治疗的2年内,接受SG治疗的个体的自付医疗费用显著低于接受奥泽米皮克治疗的个体。