OBJECTIVES: Several publications have described the challenge of therapeutic inertia, specifically the failure to intensify therapy to address poor glycemic control in a timely manner, in patients with type 2 diabetes in the UK. The aim of this modeling analysis was to quantify the economic burden of poor glycemic control due to therapeutic inertia in the UK.

METHODS: A published model of type 2 diabetes (IQVIA CORE Diabetes Model) was used to predict the cost of diabetes-related complications and lost productivity for a population with type 2 diabetes. Population characteristics were based predominantly on data from The Health Improvement Network primary care database. Complication rates, mortality and costs were estimated for populations at different levels of glycemic control across a range of delayed treatment intensification scenarios and time horizons. All costs were derived from published sources and expressed in 2017 British Pounds Sterling (GBP). Published estimates of patients failing to meet glycemic control targets in the UK were used, along with epidemiological data, to evaluate the population level burden (approximately 1,163,547 patients with type 2 diabetes were considered to have poor glycemic control).

RESULTS: Therapeutic inertia leading to 3 years of poor glycemic control (HbA1c 8.2%, 66 mmol/mol) was projected to increase the cost of complications by GBP 122 million and add GBP 930 million to lost productivity costs compared with good glycemic control (HbA1c 7.0%, 53 mmol/mol) over a 3-year time horizon. The corresponding values assuming 5 years of poor control were GBP 275 million (complication costs) and GBP 1,903 million (lost productivity), making an additional burden of GBP 2,178 million in total due to poor glycemic control at a 5-year time horizon.

CONCLUSIONS: The economic burden associated with poor glycemic control in type 2 diabetes in the UK is substantial even in the short term.