OBJECTIVES

Poorly controlled type II diabetes mellitus (T2DM) may progress to multisystem complications including diabetic kidney disease (DKD). An improved understanding of the incremental economic burden of chronic kidney disease (CKD) among patients with T2DM may be useful in economic evaluations to inform healthcare decision-making from a patient and employer perspective. The objective of this study is to compare total annual out-of-pocket costs and workplace productivity loss between patients with T2DM compared to patients with DKD.

METHODS

Data from IBM/Watson MarketScan were used to conduct this retrospective cohort analysis. Adult patients ≥18 years from 2013-2018 with service claims for T2DM were assigned to the T2DM cohort. Among the T2DM cohort, a subset of patients with service claims for CKD were assigned to the DKD cohort. All patients were continuously enrolled for 12-months prior to index date, and cohort inclusion was mutually exclusive. Subgroups for the workplace absence or short-term disability outcomes were also identified. We used Kaplan-Meier Sample Average methods to estimate outcomes using 1-month intervals during the follow-up period. Nonparametric bootstrapping with 1000 replicates to generate 95% credible intervals (CIs) were performed to measure uncertainty.

RESULTS

In the primary population (N=411,887), the mean annual out-of-pocket cost was significantly higher among patients with DKD ($151 [95% CI: $147, $153]) compared to T2DM ($118 [95% CI: $114, $124]). The mean annual productivity loss due to workplace absenteeism was found to be similar between those with DKD (227 hours [219 hours, 236 hours]) and T2DM (217 hours [187 hours, 226 hours]). Significantly higher mean annual short-term disability was observed among those with DKD (4.6 days [4.4 days, 4.8 days]) compared to those with T2DM (2.8 days [2.3 days, 3.4 days]).

CONCLUSIONS

Patients with DKD were found to have higher mean annual OOP costs and experience more days with short-term disability claims compared to patients with T2DM.