14-OR: Lifetime Medical Spending for Diabetes among Medicare Beneficiaries in the United States

Abstract

Information on lifetime medical cost of type 2 diabetes mellitus (DM) among Medicare beneficiaries is needed to assess potential economic benefits of the Medicare Diabetes Prevention Program (MDPP). We estimated lifetime incremental spending for DM by age of diagnosis and sex among Medicare beneficiaries using the 2001-2019 100% Medicare fee-for-service (FFS) claims database. We identified a cohort of persons with newly diagnosed DM in 2001 using International Classification of Diseases codes (E10 and E11), used a propensity score method to construct a non-DM comparison cohort, and then followed the two cohorts until death, discontinuation of plan coverage, or end of 2019. Lifetime medical expenditures for each cohort were estimated by aggregating the expected annual medical expenditures from age at DM diagnosis to death. Annual medical costs by age at diagnosis and sex before 2019 were derived from actual spending and those after 2019 were extrapolated using age and sex-specific expenditures from 2019. The survival rate was modeled by smoothing the annual survival rate using polynomial regression. Life-years lived with and lost to DM and lifetime excess medical expenditures of DM modeled from FFS claims cost overall and by sex are presented in the table. Despite a shorter lifespan, persons with DM had higher medical costs in their lifetime. MDPP may reduce this expenditure by helping beneficiaries prevent or delay DM. Disclosure Y.Wang: None. Y.Shao: Employee; Biogen. G.Imperatore: None. E.Luman: None. C.S.Holliday: None. P.Zhang: None.