アブストラクト | AIMS: Type 2 diabetes is a major health problem placing increasing demands on healthcare systems. Our objective was to estimate healthcare resource use and related financial costs following treatment with exenatide-based regimens prescribed as once-weekly (EQW) or twice-daily (EBID) formulations, compared with regimens based on basal insulin (BI). MATERIALS AND METHODS: This retrospective cohort study used data from the UK Clinical Practice Research Datalink (CPRD) linked to Hospital Episode Statistics (HES). Patients with type 2 diabetes who received exenatide or BI between 2009 and 2014 as their first recorded exposure to injectable therapy were selected. Costs were attributed to primary care contacts, diabetes-related prescriptions and inpatient admissions using standard UK healthcare costing methods (2014 prices). Frequency and costs were compared between cohorts before and after matching by propensity score using Poisson regression. RESULTS: Groups of 8723, 218 and 2180 patients receiving BI, EQW and EBID, respectively, were identified; 188 and 1486 patients receiving EQW and EBID, respectively, were matched 1:1 to patients receiving BI by propensity score. Among unmatched cohorts, total crude mean costs per patient-year were pound2765 for EQW, pound2549 for EBID and pound4080 for BI. Compared with BI, the adjusted annual cost ratio (aACR) was 0.92 (95% CI, 0.91-0.92) for EQW and 0.82 (95% CI, 0.82-0.82) for EBID. Corresponding costs for the propensity-matched subgroups were pound2646 vs pound3283 (aACR, 0.80, 0.80-0.81) for EQW vs BI and pound2532 vs pound3070 (aACR, 0.84, 0.84-0.84) for EBID vs BI. CONCLUSION: Overall, exenatide once-weekly and twice-daily-based regimens were associated with reduced healthcare resource use and costs compared with basal-insulin-based regimens. |
ジャーナル名 | Diabetes, obesity & metabolism |
投稿日 | 2017/2/22 |
投稿者 | Holden, Sarah E; Morgan, Christopher Ll; Qiao, Qing; Jenkins-Jones, Sara; Berni, Ellen R; Currie, Craig J |
組織名 | Pharmatelligence, Cardiff, UK.;AstraZeneca, Gothenburg, Sweden.;School of Medicine, Cardiff University, Cardiff, UK. |
Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/28218819/ |