PCV34 The Economic Burden of Cardiovascular Disease in Adults with Type 2 Diabetes in Israel

Abstract

There is a lack of comprehensive cost information on cardiovascular disease (CVD) in people with type 2 diabetes (T2D). We aimed to characterise the short-term costs after a cardiovascular (CV) event compared with baseline costs, among adults with T2D in Israel. In this retrospective cohort study using the database of the Maccabi Healthcare Services, adults aged ≥21 years with T2D who experienced their first CV event (2013–2016) were identified by adjudicated enrolment in a CV registry (ischaemic heart disease, myocardial infarction including coronary revascularisation procedure, cerebrovascular accident, transient ischaemic attack, peripheral vascular disease or heart failure). Generalised linear models estimated healthcare resource utilisation in three periods after the CV event: immediate (1 month), acute (3 months) and short-term (12 months) for all patients, survivors of 1 and 3 months’ follow up, respectively, compared with resource utilisation in the corresponding baseline period (1, 3 or 12 months before the CV event). Direct medical costs (2018 United States dollars [USD]) were estimated using the State of Israel Ministry of Health price list. Overall, 5133 adults experienced a qualifying CV event with mean (standard deviation, SD) age of 67.4 (11.8) years; 43.9% had diabetes duration >10 years. Estimated immediate costs were USD 10,741 compared with USD 2820 at baseline (cost ratio [CR]: 3.81 [99% CI 3.51–4.13]), acute costs were USD 14,586 compared with USD 5202 at baseline (CR: 2.80 [99% CI 2.61–3.01]) and short-term costs were USD 23,847 compared with USD 11,123 at baseline (CR: 2.14 [99% CI 2.03–2.27]). In adults with T2D, direct costs were 3.8-, 2.8- and 2.1-fold higher after a CV event than at baseline over immediate, acute and short-term timescales, respectively. Based on these real-world data alongside evidence over longer timescales, the economic burden of CVD complicating T2D in Israel is substantial.