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Healthcare resource utilization after initiation of sodium‐glucose co‐transporter‐2 inhibitors versus dipeptidyl peptidase‐4 inhibitors or other glucose‐lowering drugs in Japanese patients with type 2 diabetes
Author(s) -
Kohsaka Shun,
Takeda Masayoshi,
Kidani Yoko,
Yajima Toshitaka
Publication year - 2021
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.14289
Subject(s) - type 2 diabetes , medicine , dipeptidyl peptidase 4 , diabetes mellitus , propensity score matching , health care , emergency medicine , pharmacology , endocrinology , economic growth , economics
Abstract Aim To examine healthcare resource utilization in type 2 diabetes (T2D) patients after initiation of sodium‐glucose co‐transporter‐2 inhibitors (SGLT‐2is) versus dipeptidyl peptidase‐4 inhibitors (DPP‐4is) or other glucose‐lowering drugs (oGLDs). Materials and Methods A cost‐utilization analysis was performed using a nationwide hospital‐based administrative claims database (Medical Data Vision) during 2014‐2018 in Japan, where universal healthcare coverage is maintained under a single‐payer system. Data on T2D patients initiated on either SGLT‐2is or oGLDs during the study period (228 514 patients) were extracted and subjected to a 1:1 propensity score‐matching analysis (7626 patient pairs for DPP‐4is and 28 484 for oGLDs). Direct healthcare resource utilizations and inpatient and outpatient costs were compared. Results After matching, baseline characteristics were well balanced, including healthcare costs within 3 and 12 months before the index date (standardized difference <5% for all variables), with a mean age of 61.6‐64.1 years. While diabetes medication costs were higher in patients initiated with SGLT‐2is than in those initiated with DPP‐4is or oGLDs, further breakdown of individual cost components showed that SGLT‐2is were associated with a lower hospitalization frequency and a shorter total hospital stay (by 213.0 or 204.6 days/100 patient‐years compared with DPP‐4is or oGLDs, respectively; P < .001). Accordingly, overall mean cumulative cost per patient at the 2.5‐year postindex date was lower in patients with SGLT‐2is than in those with DPP‐4is or oGLDs by $2545 (1384.6‐3759.7) and $2330 (1793.1‐2882.9), respectively ( P < .001). Conclusions Our results show the benefits in healthcare resource utilization associated with SGLT‐2i use in Japanese T2D patients.