J Clin Outcomes Manage
Incidence and cost of hypoglycemia among patients with Type 2 diabetes in the United States: analysis of a health insurance database
Curkendall SM, Zhang B, Oh KS, Williams SA, Pollack MF, Graham J
ABSTRACT: Objective: To evaluate the incidence and economic impact of hypoglycemia in a cohort of patients with type 2 diabetes mellitus (T2DM). Methods: Patients > 18 years diagnosed during the period 2003 to 2008 were selected from the Thomson Reuters MarketScan databases and followed from their first diabetes diagnosis in the study period until the end of continuous coverage or 31 Dec 2008, whichever came first. All hypoglycemia events identified by a claim (ICD-9-CM 250.3, 250.8, 251.0, 251.1, 251.2) on a unique date were counted. Incidence rates were calculated overall and by treatment setting and diabetes drug regimen. Direct costs were computed per hypoglycemia event. Results: A total of 2.4 million patients with T2DM were identified, with 4.9 million patient-years (PY). Overall incidence of hypoglycemia was 3.46/100 PY (rates of 0.18, 0.05, 0.69, and 2.54 for emergency room [ER]-to-inpatient, inpatient, ER, and outpatient treatment settings, respectively). Within noninsulin antidiabetic drug (NIAD) regimens, incidence of hypoglycemia across all treatment settings was twice as high in patients prescribed regimens containing sulfonylureas (4.00 events/100 PY) than those prescribed nonsulfonylurea regimens (1.88 events/100 PY). Costs were highest for ER-to-inpatient hypoglycemia events ($10,362/event, all drug regimens) and lowest for outpatient events ($285/event, all drug regimens). Estimated hypoglycemia costs for patients on sulfonylureas were $3.87 per patient per month and $0.84 for other NIADs. Conclusion: Hypoglycemia incidence and costs among patients with T2DM?varied by drug regimen and treatment setting. Within noninsulin regimens, patients on sulfonylureas had higher incidence and costs than those on nonsulfonylurea NIADs.
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