Benter, U

Breitscheidel, L

Dippel, FW

Müller, M

Schöffski, O

Volk, M

Elsevier - Publisher Connector 

non-institutionalized population, was used. A total of 7396
adult diabetic patients were identiﬁed based on ICD-9-CM code
of 250 after excluding pregnant women and cancer patients.
These patients were classiﬁed as normal(body mass index-
(BMI):18.5 -< 25), overweight(BMI:25 -< 30), or obese(BMI:
30). TCs included all costs except for treatment of dental
problems or injuries. The impact of overweight/obesity on TCs at
various points of the cost distribution was estimated using the
weighted quantile regression model after adjusting for age,
gender, and other study variables. The effects of the study vari-
ables on the median TCs were investigated using the weighted
median regression. All costs were converted to 2005 U.S. dollars
using price indices. Data were analyzed using SAS and SUDAAN.
RESULTS: Compared with normal-weight patients, the incre-
mental TC attributable to overweight were signiﬁcantly higher
from $238, $268, $409, and $442 at the 10th, 25th, 50th, and 75th
percentile respectively. But incremental costs were diminished to
$270 at the 90th percentile because of high costs in normal
weight patients with severe comorbidities such as nephropathy.
Similar trends were found in obese-patients compared with
normal-patients, and attributable costs are bigger. Median TCs
were increased in women vs. men and Caucasian vs. African-
American, and as patients became older. CONCLUSIONS: The
impact of overweight or obesity on TCs in diabetic patients was
substantial especially in the lower tail of the TC distribution. The
study ﬁndings suggest that controlling of weight to reduce TC is
very important in most diabetic patients, but less important in
the upper tail of the TC distribution. The quantile regression
method is useful for estimating TCs at the different percentiles of
the skewed TC distribution.
DB3
HEALTH CARE RESOURCE UTILIZATION AND COSTS IN
INSULIN-DEPENDENT PATIENTS WITHTYPE 2 DIABETES
UNDER REAL WORLD CONDITIONS IN GERMANY:
LIVE-SPP STUDY
Schöffski O1, Dippel FW2, Breitscheidel L3, Benter U3, Müller M4,
Volk M4
1Universität Erlangen-Nürnberg, Nürnberg, Germany, 2Sanoﬁ-Aventis
Germany GmbH, Berlin, Germany, 3Kendle GmbH, Munich, Germany,
4axaris software&systeme GmbH, Ulm, Germany
OBJECTIVES: To evaluate and compare the total costs relevant
to diabetes care in patients with type 2 diabetes mellitus (T2D)
treated with either Insulin glargine- or conventional basal insulin
(NPH)-based therapies from the perspective of the German statu-
tory health insurance (SHI). METHODS: LIVE-SPP (Long acting
Insulin glargine Versus NPH Cost Evaluation in SPecialised Prac-
tices) Study is a naturalistic, retrolective, multicenter study of
adult patients with T2D. Costs were evaluated from the German
SHI perspective in 2005. Average total costs per patient for
Insulin glargine-based vs. NPH-based therapies were compared
over the 20-month period using multivariate general linear mod-
elling (GLM). Potential confounders tested were age, gender,
BMI, HbA1c, FBG, duration of diabetes, duration of insulin
pre-treatment, and number of diabetic complications at baseline.
Sensitivity analyses were performed by varying the main cost
factors by 25%. RESULTS: Patients (n = 1024, 512 patients
per cohort) were on average 62 years old, with an average BMI
of 30.5 kg/m2. Average duration of diabetes history at study start
was eight years with an average duration of insulin pre-treatment
of seven months. The average unadjusted total costs per patient
from the SHI perspective per 20-month period were €3114.02
[95% CI 2907.12–3320.93] for Insulin glargine-based vs.
€3439.54 [95% CI 3204.85–3674.23] for NPH-based therapies.
The major cost drivers for both cohorts were insulin utilization,
physician visits and blood glucose monitoring. Average adjusted
total costs per patient were statistically different between Insulin
glargine-based (€2068.55) and NPH-based therapies (€2679.77),
20-month period, p = 0.0004, resulting in adjusted savings of
€611.22 in favor of Insulin glargine based therapies. The eco-
nomic advantage for Insulin glargine-based therapies remained
stable in sensitivity analyses. CONCLUSIONS: LIVE-SPP cost
analyses indicate that Insulin glargine-based therapies offer an
economic advantage over NPH-based therapies, resulting in
potential cost savings.
DB4
COST OF MANAGING SEVERE HYPOGLYCAEMIA IN
INSULIN-TREATED DIABETES INTHREE EUROPEAN
COUNTRIES
Hammer M1, Lammert M2, Frier BM3
1Novo Nordisk A/S, Bagsværd, Denmark, 2Novo Nordisk Scandinavia
AB, Copenhagen, Denmark, 3Royal Inﬁrmary of Edinburgh, Edinburgh,
UK
OBJECTIVES: To assess the costs incurred in management and
follow-up of severe hypoglycaemic events (SHEs; requiring
external help for recovery) in Germany, Spain and the UK.
METHODS: In 639 people aged 16 years and receiving insulin
for type 1 (n = 319) or type 2 diabetes (n = 320) who experienced
1 SHE in the previous 12 months, health care resource use was
measured for the most recent event via patient surveys. Patients
were grouped by where the SHE was treated: Group 1, commu-
nity (lay person); Group 2, community (health care professional,
HCP); Group 3, hospital. Costs were calculated by applying unit
costs from published sources to estimated resource use; costs per
SHE were calculated by dividing by the number of patients per
subgroup. Weighted average costs across all treatment groups
were derived using prevalence data from the Roper Starch data-
base. RESULTS: Hospital treatment is a major cost driver for
SHEs in all countries, despite most patients being treated in the
community. Costs per SHE were similar for type 1 and type 2
patients in all three countries, e.g. in Germany (Groups 1–3
respectively), €52, €482 and €3671 for type 1 diabetes and €30,
€354 and €3366 for type 2 diabetes. The average cost per SHE
(all patients) for Germany, Spain and UK respectively was €522,
€466 and UK£164 (€242*) in type 1 patients and €595, €572 and
UK£358 (€527*) in type 2 patients (*€1.00 = UK£0.679; average
rate, 2/06–3/07). More patients with Type 2 than Type 1 diabetes
are treated by HCPs in the UK, resulting in higher costs. Calls
and visits to family doctors, additional glucose testing and edu-
cation about diabetes management contribute substantially to
total costs in non-hospitalised patients. CONCLUSIONS: SHEs
add signiﬁcantly to health care costs. SHE treatment costs were
similar in all three countries, despite differences in management
approach.
PODIUM SESSION IV: HEALTH POLICY ISSUES
AND IMPLICATIONS
HP1
ANALYSIS OFTHE ORPHAN DRUG DESIGNATIONS AND
APPROVALS GRANTED BYTHE EMEA ANDTHE USA FDA
BETWEEN 2000 AND 2007
Seoane-Vazquez E1, Rodriguez-Monguio R2
1The Ohio State University, Columbus, OH, USA, 2University of
Massachusetts, Amherst, MA, USA
OBJECTIVES: The United States (U.S.) Orphan Drug Act (1983)
and the European Union (EU) orphan drug legislation (2000)
established several incentives to encourage the development of
Abstracts A359


DB3 HEALTH CARE RESOURCE UTILIZATION AND COSTS IN INSULIN-DEPENDENT PATIENTS WITH TYPE 2 DIABETES UNDER REALWORLD CONDITIONS IN GERMANY: LIVE-SPP STUDY 

file:///data/core-remote/dit/data/elsevier/pdf/01b/aHR0cDovL2FwaS5lbHNldmllci5jb20vY29udGVudC9hcnRpY2xlL3BpaS9zMTA5ODMwMTUxMDY2MjM0MQ==.pdf

DB3 HEALTH CARE RESOURCE UTILIZATION AND COSTS IN INSULIN-DEPENDENT PATIENTS WITH TYPE 2 DIABETES UNDER REALWORLD CONDITIONS IN GERMANY: LIVE-SPP STUDY

Abstract

Similar works

Full text

Available Versions

Elsevier - Publisher Connector