OBJECTIVES: To analyze the medical costs of hypoglycemia in patients using basal insulin analogues in China.

METHODS: Medical record data from 4 Grade III Class A hospitals in China between 2012 and 2017 was used. Patients diagnosed with either type 1 or type 2 diabetes mellitus(T1DM/T2DM), treated with basal and ≥ 1 record of hypoglycemia in the period. Hypoglycemia was identified with glycemic value ≤3.9 mmol/L supplemented with Chinese descriptions. Patients were assigned to one of the three groups: T1DM, T2DM treated with basal insulin-only(T2DM-BOT) and T2DM treated with basal-bolus insulin(T2DM-BB). The medical costs of inpatient and outpatient visits were analyzed.

RESULTS: A total of 886 patients who had ≥ 1 record of hypoglycemia were identified including 57 T1DM patients, 522 T2DM-BOT patients and 307 T2DM-BB patients. Regarding outpatient visits due to hypoglycemia, the number of annual visits were 4.53 times(T1DM), 3.53 times(T2DM-BOT) and 2.75 times(T2DM-BB) with an overall average of 3.36 times; the medical costs of each visit were 675.78 CNY(T1DM), 916.65 CNY(T2DM-BOT) and 981.16 CNY(T2DM-BB) with an overall average of 925.00 CNY; the annual medical costs of outpatient visits were 1,148.49 CNY(T1DM), 1,552.19 CNY(T2DM-BOT) and 1,114.05 CNY(T2DM-BB) with an overall average of 1,471.57 CNY. Regarding inpatient visits due to hypoglycemia, the number of annual visits were 1.70 times(T1DM), 1.43 times(T2DM-BOT) and 1.93 times(T2DM-BB) with an overall average of 1.87 times; the medical costs of each visit were 15,085.96 CNY(T1DM), 12,213.33 CNY(T2DM-BOT) and 21,498.51 CNY(T2DM-BB) with an overall average of 20,139.77 CNY; the annual medical costs of inpatient visits were 66,348.21 CNY(T1DM), 36,639.10 CNY(T2DM-BOT) and 63,965.76 CNY(T2DM-BB) with an overall average of 62,547.09 CNY.

CONCLUSIONS: The medical costs of hypoglycemia in diabetic patients treated with basal insulin analogues in China were considerable. Treatment strategies that effectively prevent hypoglycemia are important to incur cost containment.