title: Diabetic peripheral neuropathy: resource utilization and burden of illness.
abstract: BACKGROUND
  Diabetic peripheral neuropathy (DPN) is a debilitating complication of diabetes and accounts for significant morbidity by pre-disposing the foot to ulceration and lower extremity amputation. Using a large US commercial claims database, this study analyzes the drug class usage and co-morbidities associated with DPN as well as estimates the associated economic burden.
  
  
  METHODS
  Patients older than 18 and diagnosed with DPN were followed longitudinally for 2 years pre- and post-diagnosis date. Patients were analyzed for age, gender, hospital visits, ER and doctor's office visits, pharmacy claims, co-morbidities, and drug classes prescribed pre- and post-DPN diagnosis. The economic impact post-diagnosis of DPN was compared to the patients' pre-diagnosis resource use.
  
  
  RESULTS
  In total, 10,982 incident DPN patients were identified, with a median age of 61 years, and an equal gender distribution. Post-DPN diagnosis, there was a 20% increase in the number of patients visiting hospitals and a 46% increase in the number of visits to hospitals. Further, there was a 46% increase in the annual cost per patient associated with visits to the hospitals, emergency room (ER), doctor's office, and pharmacy claims. As per the analysis presented in this study, increase in the number of visits, cost per visit, and number of patients visiting hospitals, ER and doctor's offices added up to a 46% increase in aggregated cost associated with Medical Resource Utilization (MRU) owing to DPN, with the highest increase (60%) in costs associated with hospitalization of patients with DPN.
  
  
  CONCLUSIONS
  This study highlights the high economic burden associated with DPN. The results indicate that resource use significantly increases post-diagnosis of DPN, which leads to an increase in costs for payers. A noticeable proportion of patients with DPN had a pain co-diagnosis signifying the need for treatments that can effectively manage painful DPN.
authors.affiliation: Janssen Global Services, LLC, Market Access Analytics, Global Market Access & Commercial Strategy Organization , Raritan, NJ , USA.
authors.forename: Maneesha
authors.initials: M
authors.lastname: Mehra
authors.forename: Sanjay
authors.initials: S
authors.lastname: Merchant
authors.forename: Shikha
authors.initials: S
authors.lastname: Gupta
authors.forename: Ravi C
authors.initials: RC
authors.lastname: Potluri
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003929:Diabetic Neuropathies / Q000191:economics* / Q000453:epidemiology; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000191:economics / Q000453:epidemiology; D012737:Sex Factors; D055815:Young Adult
keywords: Claims database; DPN; Diabetic peripheral neuropathy; Economic burden; Medical resource utilization