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Health Care Utilization and Costs Associated With Empagliflozin in Older Adults With Type 2 Diabetes.
Htoo, Phyo Than; NajafZadeh, Mehdi; Tesfaye, Helen; Schneeweiss, Sebastian; Wexler, Deborah J; Glynn, Robert J; Schmedt, Niklas; Déruaz-Luyet, Anouk; Koeneman, Lisette; Paik, Julie M; Patorno, Elisabetta.
Afiliación
  • Htoo PT; Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
  • NajafZadeh M; Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
  • Tesfaye H; Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
  • Schneeweiss S; Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
  • Wexler DJ; Massachusetts General Hospital Diabetes Center, Harvard Medical School, Boston, MA.
  • Glynn RJ; Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
  • Schmedt N; Global Epidemiology, Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany.
  • Déruaz-Luyet A; Global Epidemiology, Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany.
  • Koeneman L; Global Medical Affairs, Lilly Deutschland GmbH, Bad Homburg vor der Höhe, Germany.
  • Paik JM; Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
  • Patorno E; Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Diabetes Care ; 47(11): 1900-1907, 2024 Nov 01.
Article en En | MEDLINE | ID: mdl-38917305
ABSTRACT

OBJECTIVE:

We compared health care resource utilization (HCRU) and costs for inpatient and outpatient services and dispensed medications in older adults with type 2 diabetes initiating empagliflozin versus dipeptidyl peptidase 4 inhibitors (DPP-4is). RESEARCH DESIGN AND

METHODS:

The study population included U.S. Medicare fee-for-service beneficiaries with diabetes (age ≥65 years) initiating empagliflozin or DPP-4is (August 2014 to September 2018). We estimated rate ratios (RRs) for HCRU outcomes using zero-inflated negative binomial regression and per-member per-year (PMPY) cost differences using generalized linear model with gamma distributions, overall and stratified by baseline cardiovascular disease (CVD), after adjusting for 143 baseline covariates using 11 propensity score matching.

RESULTS:

We identified 23,335 matched pairs (mean age 72 years, 51% with baseline CVD). HCRU rates were lower in empagliflozin versus DPP-4i initiators (number of inpatient days, RR 0.89 [95% CI 0.82, 0.97]; number of emergency department [ED] visits, 0.86 [0.82, 0.91]; number of hospitalizations, 0.86 [0.79, 0.93]; number of office visits, 0.96 [0.95, 0.98]). Inpatient cost (-$713 PMPY [95% CI -847, -579), outpatient cost (-$198 PMPY [-272, -124]), and total cost of care (-$1,109 PMPY [-1,478, -739]) were lower for empagliflozin versus DPP-4is, although diabetes medication cost was higher in empagliflozin initiators ($454 PMPY [95% CI 284, 567]). In the CVD subgroup, total cost was lower for empagliflozin initiators (-$2,005 PMPY [-2,451, -1,337]), while the difference was attenuated in the non-CVD subgroup (-$296 PMPY [-740, 148]).

CONCLUSIONS:

Among older adults with diabetes, empagliflozin was associated with a lower number of inpatient days, hospitalizations, ED visits, and office visits and with lower costs of care compared with DPP-4is, especially in those with history of CVD.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Compuestos de Bencidrilo / Aceptación de la Atención de Salud / Diabetes Mellitus Tipo 2 / Glucósidos Límite: Aged / Aged80 / Female / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: Diabetes Care Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Compuestos de Bencidrilo / Aceptación de la Atención de Salud / Diabetes Mellitus Tipo 2 / Glucósidos Límite: Aged / Aged80 / Female / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: Diabetes Care Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos