The Economic Burden of Insulin-Related Hypoglycemia in Spain

Parekh, Witesh; Hoskins, Nicki; Baker‐Knight, James; Arellano, Antonio Ramírez de; Raya, Pedro Mezquita

doi:10.1007/s13300-017-0285-0

Cited by 21 publications

(14 citation statements)

References 21 publications

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“…Utilization of HCPs, A&E, and hospital treatment were also identified as key drivers of the model. SMBG testing and the utilization of services such as HCPs and hospitals were also key model drivers in analyses performed using the LIHT in the UK [ 5 ], Denmark, [ 6 ] and Spain [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…Hypoglycemia therefore represents a substantial economic burden to healthcare systems, with costs ranging from a few Euros for a non-severe episode, to very high costs for a severe episode requiring hospitalization of the patient [ 5 ]. Due to greater event frequency, the treatment of non-severe hypoglycemia may incur similar or greater annual costs than that of severe hypoglycemia [ 6 , 7 ]. The aim of this study was to estimate the cost of insulin-related hypoglycemia in Italy using the Local Impact of Hypoglycemia Tool (LIHT), a model used previously for analyses in the UK [ 5 ], Denmark [ 6 ] and Spain [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…Due to greater event frequency, the treatment of non-severe hypoglycemia may incur similar or greater annual costs than that of severe hypoglycemia [ 6 , 7 ]. The aim of this study was to estimate the cost of insulin-related hypoglycemia in Italy using the Local Impact of Hypoglycemia Tool (LIHT), a model used previously for analyses in the UK [ 5 ], Denmark [ 6 ] and Spain [ 7 ]. In the current analysis we also explore the potential variation in budget impact arising from different hypoglycemia rates.…”

Section: Introductionmentioning

confidence: 99%

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The Economic Burden of Insulin-Related Hypoglycemia in Adults with Diabetes: An Analysis from the Perspective of the Italian Healthcare System

Parekh

Streeton²,

Baker‐Knight³

et al. 2018

Diabetes Ther

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IntroductionThe aim of this analysis was to estimate the cost of insulin-related hypoglycemia in adult patients with diabetes in Italy using the Local Impact of Hypoglycemia Tool (LIHT), and to explore the effect of different hypoglycemia rates on budget impact.MethodsDirect costs and healthcare resource utilization were estimated for severe and non-severe hypoglycemic episodes in Italy and applied to the population of adults with type 1 diabetes (T1DM) and type 2 diabetes (T2DM) and their corresponding hypoglycemia episode rates (0.49 severe and 53.3 non-severe episodes per year for T1DM, and 0.09 severe and 9.3 non-severe episodes per year for T2DM). Uncertainty around model inputs was explored through sensitivity and scenario analyses.ResultsThe direct cost of insulin-related hypoglycemia in Italy is estimated at €144.7 million per year, with €65 million attributable to severe episodes and €79.6 million due to non-severe episodes. The total cost of hypoglycemia is approximately 1.7-fold higher for T2DM (€91.7 million) than for T1DM (€53 million). The cost of a hypoglycemic episode ranges from €4.59 for a non-severe event where additional self-monitoring of blood glucose (SMBG) testing is the only cost incurred, to €5790.59 for a severe event that also requires an ambulance, A&E, hospitalization, and a visit to a diabetes specialist. A reduction in hypoglycemia event rates could result in substantial cost savings; for example, a 20% reduction in severe and non-severe hypoglycemia rates could result in a saving of €47,769 per general population of 100,000 people.ConclusionsThe LIHT highlights the substantial economic burden of insulin-related hypoglycemia in Italy, particularly with regards to non-severe hypoglycemia, an aspect of hypoglycemia that is often overlooked. This analysis may aid healthcare decision-making by allowing the costs of insulin therapies or diabetes self-management programs to be balanced with the savings provided by reductions in hypoglycemia.FundingNovo Nordisk, UK.Electronic supplementary materialThe online version of this article (10.1007/s13300-018-0418-0) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Economic Burden of Insulin-Related Hypoglycemia in Adults with Diabetes: An Analysis from the Perspective of the Italian Healthcare System

Parekh

Streeton²,

Baker‐Knight³

et al. 2018

Diabetes Ther

Self Cite

View full text Add to dashboard Cite

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“…Reduction of 32.8% for episodes with glucose level <3.9 mmol/L (70 mg/dL) reported in the IMPACT trial, 16 for FM users was applied to non-severe hypoglycemic events. Unitary cost of €7.25/non-severe hypoglycemic episode 30 was used for the computations.…”

Section: Methodsmentioning

confidence: 99%

Cost analysis of the flash monitoring system (FreeStyle Libre 2) in adults with type 1 diabetes mellitus

Oyagüez

Merino-Torres

Brito

et al. 2020

BMJ Open Diab Res Care

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IntroductionCompare cost of the interstitial liquid glucose flash monitoring (FM) system (FreeStyle Libre 2) versus self-monitoring of blood glucose (SMBG) in adults with type 1 diabetes mellitus (T1DM) in Spain.Research design and methodsA model was developed to estimate, with the perspective of the Spanish health system, the annual costs associated with glucose monitoring and hypoglycemic events management in T1DM population, with multiple insulin daily doses (MDI). According to published evidence, rate of severe hypoglycemia (SHE) of 4.90 episodes per patient-year was applied. Reduction of SHE (58.6%) was modeled associated with FM use. Published rates of hospital care (20.2%) and subsequent admission (16%) were assumed for SHE. The daily consumption of strips and lancets was 9 in patients with SMBG (before and after 4 daily intakes and at bedtime) and 0.5 for FM users (according to IMPACT trial findings). Annual consumption of 26 FM sensors was considered (1 every 14 days). Unit costs (in € of 2019, excluding VAT) were obtained from literature and national databases. Sensitivity analyses (SA) were carried out to evaluate the model robustness.ResultsThe total annual cost/patient was €4437 for SMBG and €2526 for FM. The use of FM would be associated with an annual savings in the costs of monitoring and managing hypoglycemic events of €1911 per patient-year. In a hypothetical cohort of 1000 patients with T1DM MDI, FM could avoid in 1 year 4900 SHE, 93 hospitalizations for SHE. In addition, the use of FM would generate total savings of up to €1 910 000 per year. In the SA with alternative hypoglycemia events rates and use of strips and lancets, and including non-SHE episodes, savings from €370 000 to €1 760 000 were observed with FM.ConclusionsThe use of the FM system to monitor glucose in adults with T1DM treated with MDI, would reduce hypoglycemic events and would result in cost savings for the health system.

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“…or CCU services during hospitalization. The major driver of total direct medical costs for matched controls was outpatient visits, a small proportion of which were emergency visits, and the use of allied health Spanish population 17,33. The costs were similar to those for T2DM patients in Denmark,17 but were less than those for T2DM patients in the UK 16.…”

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confidence: 91%

Direct medical costs in the preceding, event and subsequent years of a first severe hypoglycaemia episode requiring hospitalization: A population‐based cohort study

Wong

Tong

Cheng

et al. 2019

Diabetes Obesity Metabolism

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Aims:We aimed to estimate the use of healthcare services and the direct medical costs accrued by patients with diabetes mellitus (DM) during the year of the first severe hypoglycaemia (SH) event, as well as during the years before and after the event year. Materials and Methods:We analysed a population-based, retrospective cohort including all adults with DM managed in the primary care setting from the Hong Kong Hospital Authority between 2006 and 2013. DM patients for whom SH was first recorded during the designated period were identified and matched to a control group of patients who had not experienced an SH event using the propensity score method. Direct medical costs in the years before, during and after the first SH event were determined by totalling the costs of health services utilized within respective years.Results: After matching, a total of 22 694 DM patients were divided into the first recorded-SH group (n = 11 347) and the non-SH control group (n = 11 347). Patients for whom SH was first recorded, on average, made 7.85 outpatient clinic visits, made 1.89 emergency visits and spent 17.75 nights hospitalized during the event year. Mean direct medical costs during the event year were 11 751 US$, more than 2-fold that during the preceding year (4846 US$; P < 0.001) and subsequent years (4198-4700 US$; P < 0.001) and was 4.5 times that 2 years before the event (2481 US$; P < 0.001). Incremental costs of SH patients vs matched controls during the event year and the preceding year were 10 873 US$ (P < 0.001) and 3974 US$ (P < 0.001), respectively.Conclusions: SH is associated with excessive hospital admission rates and direct medical costs during the event year and, in particular, during the year before as compared to patients who had not experienced an SH event. K E Y W O R D Scohort study, diabetes mellitus, direct medical cost, healthcare utilization, severe hypoglycaemia

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The Economic Burden of Insulin-Related Hypoglycemia in Spain

Cited by 21 publications

References 21 publications

The Economic Burden of Insulin-Related Hypoglycemia in Adults with Diabetes: An Analysis from the Perspective of the Italian Healthcare System

The Economic Burden of Insulin-Related Hypoglycemia in Adults with Diabetes: An Analysis from the Perspective of the Italian Healthcare System

Cost analysis of the flash monitoring system (FreeStyle Libre 2) in adults with type 1 diabetes mellitus

Direct medical costs in the preceding, event and subsequent years of a first severe hypoglycaemia episode requiring hospitalization: A population‐based cohort study

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