Comorbidity of Depression And Type 2 Diabetes: A Retrospective Japanese Claims Database Analysis

Abstract

Objectives: To analyze prescription patterns and the cost of antihyperglycemic drugs in patients with type 2 diabetes (T2DM) treated in Germany in 2015. MethOds: This study included 36,382 patients aged 40 years or over treated in general practices (GPs) and diabetologist practices who were diagnosed with T2DM in 2015. Nine different families of antihyperglycemic therapy were included in the analysis. Demographic data included age, gender, and type of health insurance coverage. Clinical data included HbA1c level, body mass index (BMIs), and the number of T2DM complications. The annual antihyperglycemic treatment cost per patient was calculated based on pharmacy retail prices. The multivariate regression analysis was fitted to estimate the adjusted treatment cost differences. Results: The percentage of T2DM patients receiving antihyperglycemic treatments was 87.6. This share was slightly higher in men than in women (89.1% versus 86.0%). Interestingly, the share of people treated with antihyperglycemic drugs decreased with age yet increased with HbA1c levels, BMI, and the number of complications. The average annual cost of antihyperglycemic drugs amounted to € 498. It was significantly higher in men than in women (difference of € 22). It was also significantly higher in individuals with private health insurance coverage than in people with public health insurance coverage (difference of € 153). The annual cost decreased with age. It is compelling to note that this cost increased with HbA1c levels and BMI. Finally, the annual cost also increased with the number of complications. cOnclusiOns: The share and the cost of antihyperglycemic treatments vary with gender, age, type of health insurance coverage, HbA1c levels, BMI, and the number of complications.Objectives: To estimate the relative efficacy of sodium glucose co-transporter 2 (SGLT2) inhibitors as add-on to metformin in patients with type 2 diabetes mellitus (T2DM) via indirect comparison methods. MethOds: A systematic literature review and Bayesian network meta-analyses (NMA) were conducted to assess the relative efficacy of the SGLT2 inhibitors canagliflozin (CANA), empagliflozin (EMPA), and dapagliflozin (DAPA) as add-on to metformin. Separate networks of evidence were constructed to estimate the difference in HbA1c lowering between these agents in clinical trials reporting data at 3 time points: 26 ± 4 weeks, 52 weeks, and 104 ± 2 weeks. As 2 different methods to account for missing data were used in the publications reporting 104-week results (i.e., last observation carried forward [LOCF] and mixed-model for repeated measures [MMRM]), 2 separate networks were constructed for this time point. Relative efficacy was evaluated based on surface under the curve (SUCRA) rankings, absolute differences in HbA1c reductions, and Bayesian probabilities. Results: In all networks, SUCRA rankings indicated that CANA 300 mg was the best alternative, with associated probabilities ranging from 77% to 90%. Greater HbA1c reductions were estimated for CANA 300 mg versus the h...