Elevated Costs and Healthcare Resource Utilization in Patients With Type 2 Diabetes and Established Cardiovascular Disease in Israel

Cheli Melzer Cohen*, Nino Hallén, Gabriel Chodick, Lotmit Bourvine, Tal Waner, Avraham Karasik

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: To evaluate excess healthcare resource utilization (HRU) and costs among patients with both type 2 diabetes (T2D) and established cardiovascular disease (CVD) relative to those with T2D only, in Israel. Methods: A retrospective, observational, cohort study of adult patients with T2D from the Maccabi Healthcare Services in Israel who enrolled in a cardiovascular registry between 2013 and 2016 (pre-index date period). Patients with established CVD between 2013 and 2016 were propensity matched 1:2 to control patients without established CVD. HRU and medical costs (2018 US Dollars [USD]) were extracted for a 2-year observation period (January 1, 2017, to December 31, 2018) and analyzed using generalized linear models. Results: Overall, 4,582 patients with established CVD were matched 1:2 to 9151 controls (including 13 patients matched to a single control). HRU and costs were significantly higher in patients with established CVD versus controls across a wide range of resources. In total, annual costs per patient (USD) were 10 011.8 (95% confidence interval 9,502.2; 10 548) and 7206.8 (95% confidence interval 6631.8; 7831.7) in patients with established CVD and controls, respectively. Hospitalizations, primary care visits, and medications for any condition were the main cost drivers, with greater utilization and higher costs in the established CVD group versus controls (P < .001 for all) in the postevent period. Conclusions: In a real-world setting, HRU and costs were significantly higher in patients with T2D and established CVD compared with controls across the vast majority of resource types. These up-to-date cost estimates of CVD improve our understanding of the financial implications of established CVD beyond the direct expenses.

Original languageEnglish
Pages (from-to)83-92
Number of pages10
JournalValue in Health Regional Issues
Volume22
DOIs
StatePublished - Sep 2020

Funding

FundersFunder number
Helen Marshall, of Watermeadow Medical
Novo Nordisk

    Keywords

    • cardiovascular disease
    • cost of cardiovascular complications
    • health economics
    • propensity-matched control
    • type 2 diabetes cost

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