THE BURDEN OF HYPOGLYCEMIA IN PATIENTS WITH INSULIN-TREATED DIABETES MELLITUS IN CHINA- ANALYSIS OF MEDICAL RECORD DATA
Author(s)
Yue X1, Wu J2, Ruan Z3, Wolden ML4, Li L5, Lin Y5, Guo JJ1
1University of Cincinnati, Cincinnati, OH, USA, 2The 306th Hospital of PLA, Beijing, China, 3Novo Nordisk (China) Pharmaceuticals Co., Ltd., Beijing, China, 4Novo Nordisk A/S, Søborg, Denmark, 5Shanghai Palan DataRx, Shanghai, China
OBJECTIVES:Hypoglycemia is a major risk associated with antidiabetic therapy. Although mild episodes generally are well tolerated, severe hypoglycemia can cause serious injury even death, and also lead to substantial costs of medical care and lost productivity. We assessed the rate of hypoglycemia which causes outpatient and inpatient visits and associated medical costs in patients with insulin treated diabetes in China. METHODS: A retrospective cohort study was conducted using medical records from four tertiary hospitals in China from 2012 to 2015. Study patients were included diagnosed with either type 1(T1DM) or type 2(T2DM) diabetes and treated with insulin. Both diabetes and hypoglycemia were identified with ICD-10 diagnosis codes. Hypoglycemia was also identified with glycemic value(≤3.9 mmol/L, <2.8mmol/L for severe hypoglycemia). The rate of hypoglycemia, medical resource utilization and medical costs were analyzed. One-to-one propensity score matching was used to match age, sex, and complications between patients with and without hypoglycemia. RESULTS: A total of 14,044 patients were treated with insulin, including 95.3% with T2DM and 93.7% with complications. 1,930 of patients had outpatient visits and 310 had inpatient visits due to hypoglycemia. Rates of hypoglycemia were 111 events/100 patient-year for outpatient visits and 6 events/100 patient-year for inpatient visits. Patients with hypoglycemia had more outpatient visits (8.09 vs 6.22 times/year), higher medical cost (926.6 vs 692.42 CNY /outpatient visit, 16457.5vs 13957.1 CNY/inpatient visit) and higher annual medical costs (13485.7 vs 8960.2 CNY/person) compared with patients without hypoglycemia. Patients with severe hypoglycemia had more inpatient visits (2.06 vs 1.13 times/year), higher medical cost (18994.3 vs 11988.7 CNY /inpatient visit) and higher annual medical costs (38920.3 vs 10556.6 CNY/person) compared with non-severe hypoglycemia. CONCLUSIONS: The burden of hypoglycemia is substantial and is associated with increased medical resource use and expenditures among patients with insulin-treated diabetes in China.
Conference/Value in Health Info
2018-05, ISPOR 2018, Baltimore, MD, USA
Value in Health, Vol. 21, S1 (May 2018)
Code
PDB39
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies, Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Diabetes/Endocrine/Metabolic Disorders