Economic impact of cardiovascular co-morbidity in patients with type 2 diabetes.
OBJECTIVE
To evaluate the impact of cardiovascular co-morbidity on total and diabetes-related healthcare costs in patients with type 2 diabetes.


METHODS
Retrospective analysis of the West Virginia state Medicaid claims data was conducted in patients with type 2 diabetes (ICD-9 codes: 250.0x-250.9x, where x=0 or 2) in the year 2001. Patients > or =65 years of age or those with managed care coverage were excluded. Presence of cardiovascular co-morbidity in the year 2001 was identified. Semi-logarithmic regression models were used to estimate the impact of cardiovascular co-morbidity on total and diabetes-related healthcare costs in the year 2002.Two-part models were used to study the impact of cardiovascular co-morbidity on ER/hospitalization, outpatient, and prescription costs. Smearing estimates were used to interpret the results from the semi-logarithmic models.


RESULTS
Presence of cardiovascular co-morbidity had a significant impact on all categories of total and diabetes-related healthcare costs, except diabetes-related prescription drug costs. Type 2 diabetes patients with cardiovascular co-morbidity had significantly higher total healthcare costs (38.9%, $12,550 vs. $9031), total ER/hospitalization costs (239.8%, $4845 vs. $1426), total outpatient costs (35.3%, $3956 vs. $2925), and total prescription drug costs (15.1%, $4686 vs. $4071) compared to those without cardiovascular co-morbidity. Similarly, type 2 diabetes patients with cardiovascular co-morbidity had significantly higher total diabetes-related healthcare costs (59.7%, $4349 vs. $2724), ER/hospitalization costs (346.8%, $1911 vs. $428), and outpatient costs (17.4%, $740 vs. $631) compared to patients without cardiovascular co-morbidity.


CONCLUSIONS
Presence of cardiovascular co-morbidity in patients with type 2 diabetes had a significant impact on total and diabetes-related healthcare costs.
Mody
Reema
R
TAP Pharmaceutical Products Inc., Lake Forest, IL 60045, USA. reema.mody@tap.com
Kalsekar
Iftekhar
I
Kavookjian
Jan
J
Iyer
Shrividya
S
Rajagopalan
Rukmini
R
Pawar
Vivek
V
D000328:Adult; D000553:Ambulatory Care / Q000191:economics / Q000379:methods; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000191:economics* / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000191:economics* / Q000453:epidemiology; D016527:Drug Costs; D011307:Drug Prescriptions / Q000191:economics; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008484:Medicaid / Q000191:economics; D008875:Middle Aged; D012189:Retrospective Studies; D014903:West Virginia / Q000453:epidemiology