Late Breaking Abstract - The cost, health resources utilization and medications in chronic obstructive pulmonary patients with diabetes mellitus: a population-based cohort study in Taiwan

Abstract

Background: Chronic obstructive pulmonary disease (COPD) and diabetes mellitus (DM) often coexist. The mechanistic links between these two diseases are complex, multifactorial, and not entirely understood. DM was associated with worse outcomes in COPD patients and more frequent in COPD patients. Management of DM may be important in clinical care of the COPD population. Dipeptidyl peptidase-4 (DPP-4) was highly expressed in bronchial epithelial cells of untreated chronic airway disease. Aims: We valuated the medical cost and health resource utilization between different medications for COPD patients with and without DM. Methods: We conducted a cohort study and identified 147, 073 COPD patients from Taiwan National Health Insurance Research Database (NHIRD) who had DM between 2010 and 2015. Results: After 1:1 propensity score matching, 121,844 COPD patients with DM had higher medical cost of inpatient department (IPD)(USD: 2,576*) but lower clinics visits of outpatient department (OPD)(7.56 of means of times *). Subgroup analysis showed COPD patients with DM and controlled with long-acting muscarinic antagonists had also lower OPD visit (16.75*). COPD patients with DM and controlled with DPP-4 inhibitors had higher cost and visits of OPD (USD: 51.6, 8.49*) but lower IPD clinics cost (USD: 1,803.2*), compared with cost of those controlled with traditional anti-diabetes medication (USD: 2,845.1*). Conclusion: COPD patients with DM had higher medical cost of IPD but lower health utilization of OPD. COPD patients with DM and controlled with DPP-4 inhibitors had lower clinics visit and cost of inpatient care. *: P