» Articles » PMID: 31953694

Cost of Managing Type 2 Diabetes Before and After Initiating Dipeptidyl Peptidase 4 Inhibitor Treatment: A Longitudinal Study Using a French Public Health Insurance Database

Overview
Journal Diabetes Ther
Date 2020 Jan 19
PMID 31953694
Citations 1
Authors
Affiliations
Soon will be listed here.
Abstract

Introduction: Diabetes is a growing epidemic that imposes a substantial economic burden on healthcare systems. This study aimed to evaluate the cost of managing type 2 diabetes (T2D) with dipeptidyl peptidase 4 inhibitors (DPP4Is) using real-world data.

Method: This longitudinal study used data from the French EGB (Echantillon Généraliste des Bénéficiaires) database. The annual average direct healthcare cost of treating patients with T2D was calculated 3 years prior and 3 years after initiation of DPP4I therapy. Actual total ambulatory and hospital care expenditure for the 3 years after DPP4I initiation was compared to projected costs. The distribution of costs across all care modalities was assessed over the 6-year period.

Results: Ambulatory and hospital care expenditure data for 919 patients with T2D starting DPP4I therapy alone or in combination in 2013 were analyzed. A total of 526 patients (57.2%) were still being treated with DPP4I 3 years after DPP4I initiation. Regardless of the treatment regimen, the ambulatory and hospital care costs increased above projected costs in the first year following DPP4I initiation, and then declined during the second and third years to levels in line with or below projected values for patients using DPP4Is as an add-on therapy. The increase in total expenditure in the first year following DPP4I initiation and the subsequent decline in costs in the second and third years were both associated with general trends in consumption across all aspects of patient care.

Conclusion: Despite an initial increase in healthcare expenditure, concomitant with reevaluation of patient care, this study showed that initiation of DPP4Is as an add-on therapy in French patients with T2D was associated with care expenditure that was in line or below predicted values within the 3 years following treatment initiation. Additional studies are required to evaluate the economic impact of the long-term treatment benefits.

Citing Articles

Sex, age, type of diabetes and incidence of atrial fibrillation in patients with diabetes mellitus: a nationwide analysis.

Bisson A, Bodin A, Fauchier G, Herbert J, Angoulvant D, Ducluzeau P Cardiovasc Diabetol. 2021; 20(1):24.

PMID: 33482830 PMC: 7821402. DOI: 10.1186/s12933-021-01216-7.

References
1.
Gallwitz B . Management of patients with type 2 diabetes and mild/moderate renal impairment: profile of linagliptin. Ther Clin Risk Manag. 2015; 11:799-805. PMC: 4437596. DOI: 10.2147/TCRM.S67076. View

2.
Laiteerapong N, Ham S, Gao Y, Moffet H, Liu J, Huang E . The Legacy Effect in Type 2 Diabetes: Impact of Early Glycemic Control on Future Complications (The Diabetes & Aging Study). Diabetes Care. 2018; 42(3):416-426. PMC: 6385699. DOI: 10.2337/dc17-1144. View

3.
Karagiannis T, Paschos P, Paletas K, Matthews D, Tsapas A . Dipeptidyl peptidase-4 inhibitors for treatment of type 2 diabetes mellitus in the clinical setting: systematic review and meta-analysis. BMJ. 2012; 344:e1369. DOI: 10.1136/bmj.e1369. View

4.
Valensi P, de Pouvourville G, Benard N, Chanut-Vogel C, Kempf C, Eymard E . Treatment maintenance duration of dual therapy with metformin and sitagliptin in type 2 diabetes: The ODYSSEE observational study. Diabetes Metab. 2015; 41(3):231-8. DOI: 10.1016/j.diabet.2015.03.007. View

5.
Khunti K, Seidu S . Therapeutic Inertia and the Legacy of Dysglycemia on the Microvascular and Macrovascular Complications of Diabetes. Diabetes Care. 2019; 42(3):349-351. DOI: 10.2337/dci18-0030. View