891-P: Health Care Economic Burden and Resource Utilization in Adults with Type 2 Diabetes and Myocardial Infarction

Abstract

Objectives: To evaluate health care resource utilization and cost in adults with type 2 diabetes mellitus (T2DM) and myocardial infarction (MI) . Methods: We conducted a retrospective cohort study using the Optum® Clinformatics® Data Mart claims database. Patients ≥ 18 years of age with T2DM, with or without incident MI, were identified between January 1, 2012 and December 31, 2020. Healthcare resource utilization and cost were measured in the 12 months following index. MI was defined as a hospitalization with a qualifying primary discharge diagnosis code. Patient cohorts were compared using an inverse probability of treatment weighting approach. Results: Incidence of MI was 0.7% (n = 13,681) in the one year following T2DM diagnosis. For the weighted analysis, 9,474 patients with T2DM and incident MI (mean age, 73.6; mean Charlson comorbidity index [CCI], 4.6) were compared to 9,536 patients with T2DM alone (mean age, 73.7; mean CCI, 4.7) . Compared to patients with T2DM alone, patients with T2DM and MI were more likely to have an inpatient (IP) visit (adjusted rate ratio [ARR], 5.4; 95% CI, 5.2-5.6; p < 0.01) , outpatient (OP) visit (ARR, 1.6; 95% CI, 1.6-1.6; p < 0.01) , or emergency room (ER) visit (ARR, 1.8; 95% CI, 1.7-1.8; p < 0.01) , and had longer IP length of stay (ARR, 5.4; 95% CI, 5.4-5.5; p < 0.01) . Healthcare costs from IP visits, OP visits, ER visits, and pharmacy costs were all higher in patients with T2DM and MI compared to patients with T2DM alone (Total costs, $10,929 per patient per month [PPPM] vs. $2,997 PPPM; p < 0.01) . In a hypothetical health plan population of one million adults with T2DM, we project patients with T2DM and MI would have +$676 million higher annual costs than patients with T2DM alone. Conclusions: Having MI in addition to T2DM increased healthcare resource utilization and costs. Proactively managing patients’ T2DM to reduce risk of MI and the increased healthcare utilization and costs associated with MI may improve clinical outcomes and reduce overall costs. Disclosure A.A.King: Advisory Panel; Novo Nordisk, Board Member; JDRF, Speaker's Bureau; Abbott, Dexcom, Inc., Lilly Diabetes, MannKind Corporation, Medtronic, Novo Nordisk. J.J.Rajpura: Employee; Novo Nordisk. Y.Liang: Employee; Novo Nordisk. Y.M.Paprocki: Employee; Novo Nordisk, Stock/Shareholder; Novo Nordisk. C.Uzoigwe: Employee; Novo Nordisk, Stock/Shareholder; Novo Nordisk.