THE BURDEN OF SEVERE HYPOGLICAEMIAS AND DIABETES KETOACIDOSIS- A POPULATION-BASED STUDY
Author(s)
Ciampichini R1, Cozzolino P2, Cortesi PA1, Fornari C1, Madotto F1, Chiodini V1, Mantovani LG3, Cesana G1
1University of Milano - Bicocca, Monza, Italy, 2Charta Foundation, Milan, Italy, 3Federico II University of Naples, Naples, Italy
OBJECTIVES The aim of this study was to assess the burden of severe hypoglycemia (HYPO) and diabetes ketoacidosis (DKA) in terms of incidence, treatment patterns and cost in Italy.METHODS Eligible patients were identified through a data warehouse (DENALI), which matches with a probabilistic linkage demographic, clinical and economic data of about 9.9 million individuals of Lombardy region. The study population was made of all individuals with a diagnosis of type-1 diabetes (T1DM) who, during the period 1-1-2000 to 31-12-2010 developed a first episode of severe HYPO (ICD-9-CM: 251.0-251.2) or DKA (ICD-9-CM:250.10-250.13) leading to hospitalization (index event). The identified individuals were followed-up from the index event to a maximum of 10 years. We evaluated demographic characteristics of the study population and costs (hospitalizations, drugs and outpatient examinations/visits) from the National Health Service’s perspective. RESULTS During the observational period 1,321 T1DM subjects had at least one hospital admission for HYPO (27.5%) or DKA (72.5%) event. Median age (min-max) at the first HYPO or DKA event was 66.9(1.3-96.7) and 39.4(1.0-95.7) years, respectively. The overall mortality was 14.3 deaths/100 patient-years among HYPO subjects and 7.0 among DKA ones: the difference in mortality rates between groups disappeared once controlling for age. The mean costs with 95% C.I. (€/patient-year) for HYPO and DKA patients were, respectively 10,442(8,755-12,129) and 9,720(8,659-10,782) in the event year, 10,296(8,446-12,145) and 5,805(4,539-7,071) in the year before the event, and 5,619(3,841-7,398) and 4,974(3,912-6,035) in the year after the event. Hospitalizations represented the driver of total costs: in the year of event and in the year after it varied from 70 to 56% and 76 to 60% for HYPO and DKA patients, respectively. CONCLUSIONS This study attempted to address the burden of severe T1DM HYPO and DKA events in Italy in an unselected population. The burden showed to be relevant in terms of incidence, mortality and costs.
Conference/Value in Health Info
2014-11, ISPOR Europe 2014, Amsterdam, The Netherlands
Value in Health, Vol. 17, No. 7 (November 2014)
Code
PDB119
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Diabetes/Endocrine/Metabolic Disorders