The Impact of the Use of a Digital Diabetes Management Application on HCRU-Related Costs and Pharmacy Claims in Patients With Type 2 Diabetes Mellitus

OBJECTIVES: Dario Diabetes Solution (DDS) is a digital health solution combining a smartphone application and blood glucose meter, facilitating personalized diabetes management. We report the impact of DDS use on healthcare resource utilization (HCRU)-related costs.

METHODS: Adults (≥18 years) receiving therapy for type 2 diabetes mellitus (T2DM) who used DDS (1-Jan-2017–30-Apr-2021) were linked to anonymized patient-level data from Symphony Health Integrated Dataverse (IDV). DDS users (index: first DDS registration date) were matched 1:3 using exact and propensity score-matching to non-users within IDV (index: first medical claim date in the matched annual quarter). Patients had ≥2 outpatient (≥30 days apart) or ≥1 inpatient visit during the pre-index period. All-cause per-patient-per-year (PPPY) payer costs relating to acute care (inpatient+emergency room visits), office visits (OV) and pharmacy costs were compared between cohorts at 12-month follow-up. Payer costs were estimated by applying cost-to-charge ratios to acute care/OV claim charges; pharmacy costs were identified from pharmacy claims. Costs were adjusted for baseline values using generalized linear models (following gamma distribution for acute care/OV, and normal distribution for pharmacy costs).

RESULTS: In total, 2445 DDS users were matched with 7334 non-users (mean±SD age 58.2±10.6 vs 58.3±12.5 years; 53.3% female for both). Users with acute care events (n=699 [28.6%]) incurred significantly lower costs than non-users (n=2200 [30.0%]; $12,843 vs $17,356; p=0.0001). Users with OV (n=2004 [82.0%]) incurred significantly lower costs than non-users (n=5800 [79.1%]; $2345 vs $2909; p<0.0001). Users incurred significantly higher pharmacy expenses than non-users ($11,311 vs $10,005; p<0.0001).

CONCLUSIONS: Use of a digital health solution in US patients with T2DM was associated with significant reductions in acute care and OV-related costs of over $4500 and over $500, respectively, and a slight increase in pharmacy costs. Costs savings in DDS users may be related to improved T2DM self-management; as DDS users were self-registered, underlying differences between cohorts may remain.