OBJECTIVES: To explore the impact multimorbidity (more than one chronic medical condition) has on economic burden of illness in diabetes patients.

METHODS: Data were drawn from 2018 Adelphi Diabetes Disease Specific Programme (DSP) conducted across 5EU/USA/Japan. The Diabetes DSP is a real-world, cross-sectional survey involving physicians completing forms for their next 10 consulting diabetes patients with T2DM. Patients were classified by total number of comorbidities in addition to diabetes (0; 1-2; 3-4; 5+). Physicians reported comorbidities, resource use, compliance, patient knowledge and engagement.

RESULTS: A total of 414 specialists, 588 PCPs and 9168 T2DM patients were recruited. Of these, comorbidity prevalence was as follows: diabetes-only presentation with zero additional comorbidities (20%, n=1848), 1-2 comorbidities (38%, n=3471), 3-4 comorbidities (25%, n=2249), 5+ comorbidities (17%, n=1590). 5+ comorbid patients were older than patients with zero comorbidities (67 vs. 54 years). 32% of patients with 5+ comorbidities suffer depression and/or anxiety. Economic assessment demonstrated higher burden in 5+ comorbid patients compared to zero: caregiver presence (16% vs. 1%); consultations for all conditions per year (5.9 vs. 4.0); diabetes-related hospitalizations (9% vs. 0%); higher pill burden for all comorbidities (2.2 vs. 1.5). Physicians reported 5+ comorbid patients to be less compliant (66% vs. 71%, ‘fully compliant’), less knowledgeable about their diabetes and treatment options (10% vs. 17%, ‘Very good knowledge’) and less involved in treatment decisions (13% vs. 5%,’Not at all involved’). More patients with 5+ comorbidities were treated by specialists compared to zero comorbidities (42% vs 38%). All results p< CONCLUSIONS: An absence of any current guidelines addressing multimorbidity further complicates management amongst multimorbid patients. Highly comorbid patients are likely to have a higher economic burden of illness. Coupled with higher psychological distress and higher pill burden, these patients may warrant additional care when choosing management options.