title: Health care costs associated with escalation of drug treatment in type 2 diabetes mellitus.
abstract: The cost of different intensities of therapy in HMO patients with type 2 diabetes mellitus was studied. Health care utilization data from 1995 were obtained for 12,200 registrants from the Kaiser Permanente Northwest Diabetes Registry who had type 2 diabetes mellitus. The data were used to determine costs associated with the escalation of antidiabetic therapies in persons with type 2 diabetes mellitus. The total annual costs (in 1993 dollars) associated with no drug therapy, a sulfonylurea only, metformin, a sulfonylurea plus insulin, and insulin alone were $4400, $4187, $4838, $8856, and $7365, respectively. Per patient total costs were higher for patients who had received antidiabetic therapy in 1995 or previously than for those who had not ($5303 versus $4365) and for patients who had received insulin therapy than for those who had not ($7379 versus $4117). Macrovascular complications accounted for 62-89% of the cost associated with inpatient treatment of diabetes-related complications. The total cost of treating patients with type 2 diabetes mellitus at an HMO increased as antidiabetic therapies escalated.
authors.affiliation: Kaiser Permanente Northwest Center for Health Research (KPCHR), Portland, OR, USA. jonathan.brown@kp.org
authors.forename: J B
authors.initials: JB
authors.lastname: Brown
authors.forename: G A
authors.initials: GA
authors.lastname: Nichols
authors.forename: H S
authors.initials: HS
authors.lastname: Glauber
authors.forename: A W
authors.initials: AW
authors.lastname: Bakst
authors.forename: M
authors.initials: M
authors.lastname: Schaeffer
authors.forename: C C
authors.initials: CC
authors.lastname: Kelleher
mesh_terms: D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000191:economics*; D016527:Drug Costs; D005260:Female; D017048:Health Care Costs; D006279:Health Maintenance Organizations; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use*; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D010045:Outpatients
chemical_list: D007004:Hypoglycemic Agents