Author(s)
Mennini FS1, Sciattella P1, Marcellusi A2, Bartolini F3, Bernardi FF4, Cozzolino M5, Digennaro M6, Giordana R7, Giustozzi M8, Guiducci P8, Levrat Guillen F9, Trama U4
1Economic Evaluation and HTA (EEHTA CEIS), Department of Economics and Finance, Faculty of Economics, University of Rome “Tor Vergata”, Rome, Italy, 2University of Rome “Tor Vergata”, Rome, Italy, 3USL Umbria 2, Terni, Italy, 4Campania Region, Naples, Italy, 5Directorate-General for Health Protection, Naples, Italy, 6Campania Region Healthcare System Commissioner Office, Naples, Italy, 7Central Purchasing Organism Campania Region (So.Re.Sa.), Naples, Italy, 8Umbria Digitale s.c.ar.l.,, Perugia, Italy, 9Abbott Diabetes Care, London, UK
OBJECTIVES: This study aims to define the direct healthcare costs of people with diabetes treated in Italy based on number of comorbidities and treatment regimen. METHODS: Retrospective analysis of two local health authority administrative databases (Campania and Umbria) in Italy during the period 2014-2018. Data on hospital care, pharmaceutical and specialist outpatient and laboratory assistance were collected. All people with diabetes in 2018 were identified based on at least one prescription of hypoglycemic drugs (ATC A10), hospitalization with primary or secondary diagnosis of diabetes mellitus (ICD9CM 250.xx) or diabetes exemption code (code 013). Subjects were stratified into 3 groups according to their pharmaceutical prescriptions during the year: Type 1/Type 2 (T1/T2) treated with multiple daily injections with insulin (MDI), Type 2 on basal insulin only (T2B) and Type 2 not on insulin (Oral therapy). RESULTS: In 2018, we identified 304,779 people with diabetes. Analysis was undertaken on 286,492 subjects treated with glucose-lowering drugs (13% T1/T2 MDI, 13% T2B, 74% T2 oral). Average annual cost per patient was similar for T1/T2 MDI and T2B (respectively € 2,580 and € 2,255) and significantly lower for T2 Oral (€ 1,146). Cost of hospitalization was the main driver (45% for T1/T2 MDI, 43% for T2B, 44% for T2 Oral) followed by drugs/devices (35%, 39%, 43%) and outpatient services (18%, 16%, 12%). Average costs increased considerably with increasing comorbidities: from € 416 with diabetes only to € 7,479 for a patient with 4 comorbidities. Similar trends were found across all subgroups analysis. CONCLUSIONS: Annual cost of treatment for people with diabetes is similar for those treated with MDI or with basal insulin only; hospitalization being the main cost driver. This indicates that both patient groups should benefit from having access to a glucose-sensing technology which is known to be associated with reduced hospitalization for acute diabetes events.
Conference/Value in Health Info
2022-11, ISPOR Europe 2022, Vienna, Austria
Value in Health, Volume 25, Issue 12S (December 2022)
Code
EE239
Topic
Economic Evaluation, Epidemiology & Public Health, Medical Technologies, Study Approaches
Topic Subcategory
Medical Devices
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity), STA: Medical Devices