title: Distribution and drivers of costs in type 2 diabetes mellitus treated with oral hypoglycemic agents: a retrospective claims data analysis.
abstract: OBJECTIVE
  To describe the distribution of costs and to identify the drivers of high costs among adult patients with type 2 diabetes mellitus (T2DM) receiving oral hypoglycemic agents.
  
  
  METHODS
  T2DM patients using oral hypoglycemic agents and having HbA1c test data were identified from the Truven MarketScan databases of Commercial and Medicare Supplemental insurance claims (2004-2010). All-cause and diabetes-related annual direct healthcare costs were measured and reported by cost components. The 25% most costly patients in the study sample were defined as high-cost patients. Drivers of high costs were identified in multivariate logistic regressions.
  
  
  RESULTS
  Total 1-year all-cause costs for the 4104 study patients were $55,599,311 (mean cost per patient = $13,548). Diabetes-related costs accounted for 33.8% of all-cause costs (mean cost per patient = $4583). Medical service costs accounted for the majority of all-cause and diabetes-related total costs (63.7% and 59.5%, respectively), with a minority of patients incurring >80% of these costs (23.5% and 14.7%, respectively). Within the medical claims, inpatient admission for diabetes-complications was the strongest cost driver for both all-cause (OR = 13.5, 95% CI = 8.1-23.6) and diabetes-related costs (OR = 9.7, 95% CI = 6.3-15.1), with macrovascular complications accounting for most inpatient admissions. Other cost drivers included heavier hypoglycemic agent use, diabetes complications, and chronic diseases.
  
  
  CONCLUSIONS
  The study reports a conservative estimate for the relative share of diabetes-related costs relative to total cost. The findings of this study apply mainly to T2DM patients under 65 years of age.
  
  
  CONCLUSIONS
  Among the T2DM patients receiving oral hypoglycemic agents, 23.5% of patients incurred 80% of the all-cause healthcare costs, with these costs being driven by inpatient admissions, complications of diabetes, and chronic diseases. Interventions targeting inpatient admissions and/or complications of diabetes may contribute to the decrease of the diabetes economic burden.
authors: Takeda Pharmaceuticals International, Inc. , Deerfield, IL , USA.
authors: Morgan
authors: M
authors: Bron
authors: Annie
authors: A
authors: Guerin
authors: Dominick
authors: D
authors: Latremouille-Viau
authors: Raluca
authors: R
authors: Ionescu-Ittu
authors: Prabhakar
authors: P
authors: Viswanathan
authors: Claudia
authors: C
authors: Lopez
authors: Eric Q
authors: EQ
authors: Wu
mesh_terms: D000284:Administration, Oral; D002908:Chronic Disease; D015897:Comorbidity; D003365:Costs and Cost Analysis; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000191:economics*; D005260:Female; D006442:Glycated Hemoglobin; D006801:Humans; D007004:Hypoglycemic Agents / Q000191:economics* / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D012189:Retrospective Studies
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents
keywords: Cost distribution; Cost drivers; Type 2 diabetes