title: Healthcare utilization and costs in diabetes relative to the clinical spectrum of painful diabetic peripheral neuropathy.
abstract: OBJECTIVE
  Diabetic peripheral neuropathy (DPN) accompanied by painful symptoms is known as painful DPN (pDPN). This study characterized healthcare resource utilization and costs in patients with DPN, pDPN, and severe pDPN relative to diabetes only.
  
  
  METHODS
  Four adult cohorts were identified from the Humedica database: type 2 diabetes without DPN (n=288,328); DPN (n=35,050); pDPN (DPN subjects with a pain score ≥1 on a 0-10 numeric rating scale; n=3449); and severe pDPN (pain scores 7-10; n=1824). Resource utilization and costs for 12-months post-diagnosis were compared for diabetes relative to the other cohorts.
  
  
  RESULTS
  Demographic characteristics were different across cohorts. Relative to diabetes alone, DPN, pDPN, and severe pDPN were characterized by significantly higher proportions of patients with resource utilization for all resource categories (all P<0.0001); the highest resource use generally observed for severe pDPN. Total annual direct medical costs were $6632 for diabetes only, with costs for DPN ($12,492), pDPN ($27,931), and severe pDPN ($30,755) significantly higher (all P<0.0001); outpatient costs were consistently the primary driver of total costs.
  
  
  CONCLUSIONS
  Patients with DPN, pDPN, and severe pDPN had significantly greater healthcare resource utilization and costs than patients with diabetes only, with the highest burden associated with severe pDPN.
authors.affiliation: Pfizer, Inc., New York, NY, USA. Electronic address: alesia.sadosky@pfizer.com.
authors.forename: Alesia
authors.initials: A
authors.lastname: Sadosky
authors.affiliation: Pfizer, Inc., New York, NY, USA.
authors.forename: Jack
authors.initials: J
authors.lastname: Mardekian
authors.affiliation: Pfizer, Inc., New York, NY, USA.
authors.forename: Bruce
authors.initials: B
authors.lastname: Parsons
authors.affiliation: Pfizer, Inc., New York, NY, USA.
authors.forename: Markay
authors.initials: M
authors.lastname: Hopps
authors.affiliation: Outcomes Research Consultant, New York, NY, USA.
authors.forename: E Jay
authors.initials: EJ
authors.lastname: Bienen
authors.affiliation: Translational Pain Research Program, Department of Neurosurgery, University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: John
authors.initials: J
authors.lastname: Markman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003131:Combined Modality Therapy / Q000191:economics; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy / Q000191:economics / Q000628:therapy; D003929:Diabetic Neuropathies / Q000188:drug therapy / Q000191:economics / Q000503:physiopathology / Q000628:therapy*; D057286:Electronic Health Records; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010342:Patient Acceptance of Health Care; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014481:United States; D055815:Young Adult
keywords: Costs; Diabetes; Electronic medical records; Healthcare utilization; Pain severity; Painful diabetic peripheral neuropathy