Healthcare Resource Utilization in Patients with Type 1 Diabetes with or without Prior Type 2 Diabetes Misdiagnosis: A Study in a U.S. Managed Care Population
Author(s)
Diana Brixner, RPh, PhD1, Tariku J. Beyene, PhD2, Malvika Venkataraman, Phd2, Hung-Yuan P. Chen, Phd2, Chia-Chen Teng, Phd2, Hiangkiat Tan, Phd2, Laura R. Wilson, PharmD3, Andrew Cagle, MD, FAAP, BCMAS3, Daniel Malone, BS, RPh, PhD1.
1University of Utah College of Pharmacy, Salt Lake City, UT, USA, 2Carelon Research, Wilmington, DE, USA, 3Sanofi, Bridgewater, NJ, USA.
1University of Utah College of Pharmacy, Salt Lake City, UT, USA, 2Carelon Research, Wilmington, DE, USA, 3Sanofi, Bridgewater, NJ, USA.
Presentation Documents
OBJECTIVES: To examine healthcare resource utilization (HCRU) in patients with type 1 diabetes (T1D) with and without prior type 2 diabetes (T2D).
METHODS: This observational cohort study assessed administrative claims from the Healthcare Integrated Research Database (October 1, 2015, to December 31, 2023). Patients with ≥2 outpatient claims for T1D 30-183 days apart or ≥1 inpatient claim (first T1D diagnosis was the index) and ≥12 months’ continuous medical and pharmacy benefit before (baseline) and after index (follow-up) were included. Patients with ≥2 T2D diagnoses or ≤1 T1D diagnosis during 12-month follow-up, or secondary diabetes or pregnancy during 12-month baseline, were excluded. All-cause HCRU in patients with T1D with and without prior T2D diagnosis at baseline was assessed by age and overall.
RESULTS: In qualifying individuals with T1D, 2624 (31%) had a prior T2D diagnosis (41% female; mean age: 45 years; <18 years: 6%), and 5953 (69%) had no prior T2D diagnosis (42% female; mean age: 27 years; <18 years: 46%). Compared with those who had a prior T2D diagnosis, those without were less likely to experience inpatient admissions (11% vs 3% [<18 years: 16% vs 1%; ≥18 years: 11% vs 5%]; all p<0.001), emergency department visits (24% vs 11% [<18 years: 44% vs 12%; ≥18 years: 23% vs 10%]; all p<0.001), outpatient visits (99% vs 81%, p<0.001 [<18 years: 98% vs 90%, p=0.002; ≥18 years: 99% vs 73%, p<0.001]), laboratory procedures (88% vs 53% [<18 years: 85% vs 57%; ≥18 years: 88% vs 49%]; all p<0.001), and to be receiving medications (94% vs 75% [<18 years: 82% vs 63%; ≥18 years: 95% vs 84%]; all p<0.001) at baseline.
CONCLUSIONS: Individuals with T1D misdiagnosed with T2D incurred greater HCRU.
METHODS: This observational cohort study assessed administrative claims from the Healthcare Integrated Research Database (October 1, 2015, to December 31, 2023). Patients with ≥2 outpatient claims for T1D 30-183 days apart or ≥1 inpatient claim (first T1D diagnosis was the index) and ≥12 months’ continuous medical and pharmacy benefit before (baseline) and after index (follow-up) were included. Patients with ≥2 T2D diagnoses or ≤1 T1D diagnosis during 12-month follow-up, or secondary diabetes or pregnancy during 12-month baseline, were excluded. All-cause HCRU in patients with T1D with and without prior T2D diagnosis at baseline was assessed by age and overall.
RESULTS: In qualifying individuals with T1D, 2624 (31%) had a prior T2D diagnosis (41% female; mean age: 45 years; <18 years: 6%), and 5953 (69%) had no prior T2D diagnosis (42% female; mean age: 27 years; <18 years: 46%). Compared with those who had a prior T2D diagnosis, those without were less likely to experience inpatient admissions (11% vs 3% [<18 years: 16% vs 1%; ≥18 years: 11% vs 5%]; all p<0.001), emergency department visits (24% vs 11% [<18 years: 44% vs 12%; ≥18 years: 23% vs 10%]; all p<0.001), outpatient visits (99% vs 81%, p<0.001 [<18 years: 98% vs 90%, p=0.002; ≥18 years: 99% vs 73%, p<0.001]), laboratory procedures (88% vs 53% [<18 years: 85% vs 57%; ≥18 years: 88% vs 49%]; all p<0.001), and to be receiving medications (94% vs 75% [<18 years: 82% vs 63%; ≥18 years: 95% vs 84%]; all p<0.001) at baseline.
CONCLUSIONS: Individuals with T1D misdiagnosed with T2D incurred greater HCRU.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE272
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)