2226-PUB: Direct Sanitary Cost of Diabetes Mellitus Ambulatory Treatment in the Institute of Prevision Social of Paraguay

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The Institute of Prevision Social (IPS), social security of Paraguay is responsible for the complete provision of diseases treatment of the worker and his family. Diabetes mellitus (DM) is one of the most prevalent diseases in our country. Aim: To determine the direct health cost of DM outpatient treatment (medications and medical visits) of IPS in 2018. Methods: Observational, descriptive, transverse. Data were collected on the type and quantity of antidiabetic medication consumed and the number of visits per patient with type 1 and 2 DM, of the computer registry: “SIH” from January to December 2018, available at all IPS centers in the country. Results: 67,664 patients who received antidiabetic medication were included. Female 50.5%, age 64.5 ± 21.53 years. 79.7% use oral medication (1 or more drugs.) 30.3% use insulins (alone or in combination). In order of frequency, the most commonly used drugs are: Metformin 73% Glimepiride 41%, Insulin NPH 20% Basal insulin analogues 16%, Regular Insulin 5.4% Sitagliptin. 2% and ultrarapid analogs 1.8% of the total population. One visit per patient was averaged every 3.7 months with the internist, family doctor or endocrinologist; cost of $ 7,14/visit (stipulated by the Paraguayan Society of Internal Medicine), which yields an annual cost of outpatient visits of $2,166,720. The estimated annual cost used in antidiabetic medications was $ 3,842,977: Basal insulin analogs $ 1,802,808, NPH insulin $ 811,260, Ultrarapid insulin analogs $ 568,788, , Metformin $ 330,249, Sitagliptin $ 167,754, Glimepiride $ 103,656, Human rapid insulin 58,433 $; averaging a cost per patient of $ 89 per year. Conclusion: The high costs generated by the disease, even without the calculation of hospitalizations, complications, work disability, suggests the need to promote primary prevention policies for DM. On the other hand, the optimization of health resources, using cost/effective medication, could help reduce health expenditure in our institution. Disclosure S.P. Arzamendia: None. F. Romero: None. E. Valinotti: None.