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患有2型糖尿病和肥胖症的商业保险人群的自付费用:奥泽米皮克与袖状胃切除术的比较。

Out-of-Pocket Costs among Commercially Insured Individuals with type 2 Diabetes and Obesity: Comparison between Ozempic and Sleeve Gastrectomy.

作者信息

Edwards Michael A, Wall-Wieler Elizabeth, Liu Yuki, Zheng Feibi, Coviello Andrea

机构信息

Department of Medicine, University of North Carolina.

Global Health Economics and Outcomes Research, Intuitive Surgical.

出版信息

Ann Surg. 2024 May 22. doi: 10.1097/SLA.0000000000006353.

Abstract

OBJECTIVE

Determine out-of-pocket (OOP) costs two years after sleeve gastrectomy (SG) or initiating Ozempic for patients with type 2 diabetes (T2D) and obesity.

SUMMARY BACKGROUND DATA

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

Within 2 years of starting treatment, OOP healthcare costs were significantly lower among individuals who had a SG versus those treated with Ozempic.

摘要

目的

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。

总结背景数据

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。

方法

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。

结果

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)。

结论

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。

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