Cardiovascular Disease Mortality Associated With Increased Costs Among Patients With Diabetes

Patients with type 2 diabetes who suffer fatal cardiovascular disease (CVD) events have significantly increased health care costs during the last year of treatment, according to recent research presented at AMCP Nexus 2016.

“Patients with type 2 diabetes mellitus are at an increased risk of death from CVD; however, the direct cost of CVD-related death among patients with type 2 diabetes mellitus is largely unknown,” Sharash Shetty, PhD, product director of HEOR Metabolics at Boehringer Ingelheim, and colleagues wrote in their presentation.

In order to “determine the incremental direct economic burden of CVD-related death in patients with type 2 diabetes mellitus, in the 3-, 6-, and 12-months prior to their death,” the researchers conducted a retrospective, matched cohort study using the IMS LifeLink PharMetrics Plus claims database. The researchers matched 19,204 adult patients aged older than 18 years with type 2 diabetes who died of CVD events against 7648 similarly aged patients with type 2 diabetes but no evidence of CVD death on record. They assessed costs at 3, 6, and 12 months before the date of death, using statistical analysis to compare differences between the two study groups. The researchers also assessed health care resource utilization, such as length of stay (LOS), bed days during hospitalization, and number of CVD-related hospital visits. 

Study results showed that resource usage and total costs were significantly higher among patients who died of CVD-related complications. A significantly greater portion of patients who died used inpatient hospital (71.9% vs 18.5%) and emergency department (62.5% vs 24.6%) resources; whereas, patients who did not die used physicians offices (99.2% vs 97.5%) and pharmacies (80.2% vs 77.7%) more than those who did die from CVD.

The researchers also found that patients who died from CVD had significantly higher LOS (5.2 days vs 1.3 days) and had a higher number of annual average bed days (13.5 days vs 2.8 days) than patients who did not die. 

In terms of costs, the researchers found that over the last year of treatment, patients who died had significantly higher health care costs than patients who did not die, especially in the final 3 months of treatment ($36,076 vs $6319). Average total health care costs of the final year of treatment were also significantly higher among patients who died, with $67,922 in costs compared to $18,119 among patients who did not die.

This research was funded by Boehringer Ingelheim Pharmaceuticals. —David Costill