title: Weight change and healthcare resource use in English patients with type 2 diabetes mellitus initiating a new diabetes medication class.
abstract: OBJECTIVE
  The aim of this study was to investigate the association between weight change and healthcare resource use (HCRU) and costs in English primary care patients with type 2 diabetes mellitus (T2DM) initiating treatment with a new diabetes medication class.
  
  
  METHODS
  Patients diagnosed with T2DM initiating a new diabetes medication class (first-line, switch or add-on treatment) were selected from Clinical Practice Research Datalink. Weight change (index date) was measured 6 months after initiating new treatment. HCRU was derived up to 1 year after index. Adjusted analyses evaluated the association between weight change and HCRU and costs (GBP, 2013 prices).
  
  
  RESULTS
  Of 9031 patients, about half (n = 4901) experienced < 3% weight change (weight neutral); the proportions gaining or losing weight were similar. Compared with the weight neutral group, weight gain was associated with significantly increased total costs within a year (3.0-5.4% weight gain: £58.9; p = 0.01, ≥ 5.5% weight gain: £52.9; p = 0.04) and diabetes primary care costs (3.0-5.4% weight gain: £29.2; p < 0.001, ≥ 5.5% weight gain: £34.2; p < 0.001). This included increased rates of prescribing drugs for diabetes and, in ≥ 5.5% weight gain, increased primary care contacts. A ≥ 5.5% weight loss was associated with increased hospital admissions (odds ratio = 1.4; p < 0.0001) and total costs (£126.3; p < 0.001).
  
  
  CONCLUSIONS
  Weight gain after initiating a new glucose-lowering medication is associated with increased prescribing and contact with primary care clinicians, with increased costs in primary care and total spending. This study supports that weight gain in diabetes is associated with increased healthcare costs.
authors.affiliation: Payer Evidence, AstraZeneca, Luton, UK.
authors.forename: B T
authors.initials: BT
authors.lastname: Blak
authors.affiliation: Payer Evidence, AstraZeneca, Luton, UK.
authors.forename: U
authors.initials: U
authors.lastname: Rigney
authors.affiliation: Global Medicines Development, AstraZeneca, Mölndal, Sweden.
authors.forename: C
authors.initials: C
authors.lastname: Sternhufvud
authors.affiliation: MASD, US Payer & Real World Evidence, AstraZeneca, Wilmington, DE, USA.
authors.forename: J
authors.initials: J
authors.lastname: Davis
authors.affiliation: Global Medicines Development, AstraZeneca, Mölndal, Sweden.
authors.forename: N
authors.initials: N
authors.lastname: Hammar
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000191:economics; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000191:economics / Q000706:statistics & numerical data*; D006113:United Kingdom; D015430:Weight Gain; D015431:Weight Loss