OBJECTIVES

Limited data is available on the costs of cardiovascular complications (CVC) of diabetes in France while health technology assessment of antihyperglycemic therapy requires substantiated information. We estimated direct and indirect costs of these CVC through the National French healthcare claims database SNDS.

METHODS

SNDS includes both ambulatory and hospital care and allow to estimate both direct costs and productivity losses. CVC complications were identified among patients with Type 2 diabetes (T2DM) in 2015. Costs of non-fatal myocardial infarction, stroke, transient attack and peripheral arterial disease were estimated comparing biannual resource consumption after event index date to projected costs from the previous period (Group 1). Cost of one-off hospitalized events (fatal events, hospitalization for cardiac failure hospitalized hypoglycemia, diabetes related comas) where estimated only considering direct hospitalization costs using French National Hospital Costs study (Group 2).

RESULTS

A total of 25,812 patients and 32,743 patients were included respectively in the Group 1 and Group 2. Among Group1 diseases, costs were significantly increased in the semester after the index date due to hospital stays but return in most cases to an expected level after 6 months. For example, average direct cost of non-fatal MI was estimated to be €11,977 over the 6 months following the event but only 647 € during the next semester. Average indirect costs represented a small part of overall CVC costs due to the age of the patients (i.e. 13.2% for MI over the first year). In Group 2 hospital costs were estimated to €4,580 and €5,085 per event for hypoglycemia and cardiac failure.

CONCLUSIONS

This study provides a comprehensive view of costs related to CVC in patients with T2DM in France in a collective perspective and considering time from the event. Results would be helpful in conducting cost-effectiveness appraisal of new antihyperglycemic therapies with cardiovascular protection.