OBJECTIVES

Hypoglycemia is one of the most common acute complications during diabetes treatments. This study reviews and assesses economic burden of hypoglycemia in patients with diabetes mellitus (DM) in China.

METHODS

A literature review was conducted by key words including cost, economic burden, healthcare utilization, and/or health-related expenditure associated with hypoglycemia in patients with DM in China, published in either Chinese or English. PubMed, China National Knowledge Infrastructure (CNKI), Wanfang Data, and academic conference abstracts were searched through April 2019.

RESULTS

There were 15 publications identified; 4 articles and 4 abstracts were selected; 7 publications were excluded with criteria of non-peer reviews and non-original data. All study designs were retrospective. The data sources of patient surveys, hospital electronic medical records, and medical insurance claims data were applied.

In summary, current available evidence revealed hypoglycemia significantly consumed healthcare resources and induced non-medical costs including work absences and transportation fees. The total cost per patient of hypoglycemia was 1,513~5,560.76 CNY/event or 658.1~5985.8 CNY/year based on severity and frequency. Medical costs for DM with hypoglycemia episodes were considerable (667~925 CNY/outpatient visit, 5,904~20,140 CNY/inpatient visit) and higher than non-DM (increased 414 and 1,113 CNY respectively). By controlling confounding factors and comparing with non-hypoglycemia cohort, the associations of hypoglycemia with healthcare resource utilization and cost were further estimated. The facts were confirmed that patients experiencing hypoglycemia had significant higher all-cause cost (increased 4,526~8,358 CNY/person/year for all event, Incremental 10,873 USD/person/year or 28,364 CNY/person/year for severe vs. non-severe episodes), diabetes-specific cost (increased 1,663 CNY/visit or 3,424 CNY/person/year), outpatient visits (increased 1.87~3.2 times/year and 234~7,153 CNY/visit), and hospitalization (increased proportion by 5.6%~25.66% and admission cost by 2,500~17,284 CNY, prolonged length of stay by 2.5 days).

CONCLUSIONS

Hypoglycemia events significantly increase cost and healthcare resource utilization for DM in China.