PDB47 - THE ASSOCIATION BETWEEN RENAL FUNCTION AND HEALTHCARE COSTS IN US PATIENTS WITH TYPE 2 DIABETES

Abstract

Examine healthcare costs for US patients with type 2 diabetes (T2D) and comorbid chronic kidney disease (CKD) IQVIA linked claims and medical records from January 1, 2012 through March 31, 2017 were used for this retrospective study. Patients age 18 and older, diagnosed with T2D, and identified with CKD were included. Patients with type 1 diabetes, pregnancy, or without continuous insurance coverage from the date first identified with CKD (the index date) through the 1-year post-period were excluded from the study. General linear models incorporating splines were constructed and information from these regressions were used to inform whether the relationship between costs and CKD would best be captured by incorporating non-linearities. These models also controlled for patient characteristics, vital signs, general health, prior medication use, prior visit to specialists, index A1c, and year of index date. There were 6,645 individuals who fit the study inclusion and exclusion criteria – 3,189 with Stage 1 or 2 CKD, 1,441 in Stage 3a, 1,184 in Stage 3b, 449 in Stage 4 and 382 in Stage 5. Results generally indicate sharp increases in total medical costs and non-drug medical costs for patients with Stage 4 or 5 CKD (estimated glomerular filtration rate [eGFR] ≤ 30 mL/min/1.73m2) with each 1 point reduction in eGFR from 30 associated with an increase of $1,870 in all-cause total medical costs (P<0.0001) and $1,805 of all-cause non-drug costs (P<0.0001). Similarly, each point decline below 30 mL/min was associated annual costs increases of $1,701 for CKD-related total medical costs, $1,695 for CKD-related non-drug costs, $174 for diabetes-related medical costs, and $187 for diabetes-related non-drug costs (all P<0.0001). Results indicate there are sharp and significant increases in medical costs among T2D patients with Stage 4 and 5 CKD compared to those with earlier stages of CKD.