Introduction:
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.
Conclusion:
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.
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DOI: 10.1038/s41582-024-01041-y.
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DOI: 10.1371/journal.pone.0297110.
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PMC: 10053786.
DOI: 10.3389/fendo.2023.1046690.
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PMID: 36051389
PMC: 9424503.
DOI: 10.3389/fendo.2022.969149.
Vibrotactile perception on the sole of the foot in an older group of people with normal glucose tolerance and type 2 diabetes.
Peterson M, Pingel R, Rolandsson O, Dahlin L
SAGE Open Med. 2020; 8:2050312120931640.
PMID: 32587694
PMC: 7294473.
DOI: 10.1177/2050312120931640.
(Cost-)effectiveness of lower extremity nerve decompression surgery in subjects with diabetes: the DeCompression (DECO) trial-study protocol for a randomised controlled trial.
Rinkel W, Fakkel T, Cabezas M, Birnie E, Coert J
BMJ Open. 2020; 10(4):e035644.
PMID: 32341044
PMC: 7204866.
DOI: 10.1136/bmjopen-2019-035644.
Prevalence of diabetic peripheral neuropathy in Africa: a systematic review and meta-analysis.
Shiferaw W, Akalu T, Work Y, Aynalem Y
BMC Endocr Disord. 2020; 20(1):49.
PMID: 32293400
PMC: 7158034.
DOI: 10.1186/s12902-020-0534-5.
The risk factors for diabetic peripheral neuropathy: A meta-analysis.
Liu X, Xu Y, An M, Zeng Q
PLoS One. 2019; 14(2):e0212574.
PMID: 30785930
PMC: 6382168.
DOI: 10.1371/journal.pone.0212574.
Acupoint Therapy on Diabetes Mellitus and Its Common Chronic Complications: A Review of Its Mechanisms.
Feng Y, Fang Y, Wang Y, Hao Y
Biomed Res Int. 2018; 2018:3128378.
PMID: 30426006
PMC: 6217896.
DOI: 10.1155/2018/3128378.
Herbal medicine foot bath for the treatment of diabetic peripheral neuropathy: protocol for a randomized, double-blind and controlled trial.
Fan G, Huang H, Lin Y, Zheng G, Tang X, Fu Y
Trials. 2018; 19(1):483.
PMID: 30201043
PMC: 6131772.
DOI: 10.1186/s13063-018-2856-4.
Efficacy of epalrestat plus α-lipoic acid combination therapy monotherapy in patients with diabetic peripheral neuropathy: a meta-analysis of 20 randomized controlled trials.
Zhao M, Chen J, Chu Y, Zhu Y, Luo L, Bu S
Neural Regen Res. 2018; 13(6):1087-1095.
PMID: 29926837
PMC: 6022459.
DOI: 10.4103/1673-5374.233453.
Omega-3 polyunsaturated fatty acid supplementation for improving peripheral nerve health: protocol for a systematic review.
Zhang A, MacIsaac R, Roberts L, Kamel J, Craig J, Busija L
BMJ Open. 2018; 8(3):e020804.
PMID: 29581208
PMC: 5875591.
DOI: 10.1136/bmjopen-2017-020804.
Clinical and economic burdens experienced by patients with painful diabetic peripheral neuropathy: An observational study using a Japanese claims database.
Ebata-Kogure N, Nozawa K, Murakami A, Toyoda T, Haga Y, Fujii K
PLoS One. 2017; 12(10):e0187250.
PMID: 29077757
PMC: 5659791.
DOI: 10.1371/journal.pone.0187250.
Thymoquinone Alleviates the Experimental Diabetic Peripheral Neuropathy by Modulation of Inflammation.
Chen L, Li B, Chen B, Shao Y, Luo Q, Shi X
Sci Rep. 2016; 6:31656.
PMID: 27545310
PMC: 4992870.
DOI: 10.1038/srep31656.
Contractile apparatus dysfunction early in the pathophysiology of diabetic cardiomyopathy.
Waddingham M, Edgley A, Tsuchimochi H, Kelly D, Shirai M, Pearson J
World J Diabetes. 2015; 6(7):943-60.
PMID: 26185602
PMC: 4499528.
DOI: 10.4239/wjd.v6.i7.943.