Meyers J, Hoog M, Mody R, Yu M, Hasenour C, Davis KL. Burden of cardiovascular disease and cardiovascular (CV) risk in patients with Type 2 diabetes mellitus (T2DM): an analysis of a US health insurance database. Poster presented at the 2020 ISPOR Virtual Conference; May 2020. [abstract] Value Health. 2020 May 1; 23(Suppl 1):S115. doi: 10.1016/j.jval.2020.04.371.

OBJECTIVES: To estimate T2DM and CV-related health care resource utilization (HCRU) and costs among patients with T2DM and cardiovascular disease (CVD; e.g., stroke) or CV risk factors (CV risk; e.g., hypertension) in the United States.

METHODS: Patients with ≥24 months of continuous enrollment were selected from MarketScan Commercial and Medicare databases from 1/1/2014-9/30/2018. Months 1-12 designated the baseline period and months 13-24 designated the follow-up period. Patients were required to have evidence of T2DM during the baseline period. From the overall T2DM population, two cohorts were created based on baseline diagnoses: patients with CVD (CVD cohort), and patients with CV risk but no CVD (CV risk cohort). Annual all-cause, T2DM-, and CVD-related HCRU and costs were reported during baseline. The proportion of all-cause costs attributable to T2DM and CVD were reported.

RESULTS: The overall T2DM population included 1,106,716 patients (224,018 CVD cohort, 812,144 CV risk cohort; 70,554 neither cohort). Any hospitalization during the baseline period was higher in the CVD cohort (32.4%), compared with CV risk (6.3%) and overall T2DM (11.5%). T2DM-related (9.6%) and CVD-related (7.7%) emergency department visits were lowest in the CV risk cohort, compared to the overall T2DM cohort (11.4%; 9.7%) and CVD cohort (18.3%; 19.0%). During baseline, all-cause ($38,985), CVD-related ($16,208) and T2DM-related ($18,842) costs were highest for the CVD cohort, compared with the overall T2DM ($18,296; $7,368; $5,921) and CV risk ($13,207; $5,226; $2,754) cohorts. During baseline, 40.3%, 41.6%, and 39.6% of all-cause costs were T2DM-related and 32.4%, 48.3%, and 20.9% were CVD-related in the overall T2DM, CVD, and CV risk cohorts.

CONCLUSIONS: Hospital admission and emergency department visits were highest among patients with CVD, compared with overall T2DM and CV risk patients. All-cause costs were also higher for CVD patients, with a greater proportion being CVD-related compared to other cohorts.

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