¿Qué gasto farmacológico genera un diabético bien controlado?

Abstract

Objective To evaluate the cost of glucose lowering treatment (GLT) in our diabetic patiients (DP). Design Cross-sectional descriptive study. Setting Urban primary health care centre. Participants Random sample of 294 DP with HPT. Measurements Principal variable: annual cost of GLT. Secondary Variables: age, sex, type of diabetes (DM), prescribing doctor, level of control, number of glucose lowering drugs, cardiovascular risk factors and complications. Results A total of 294 diabetic patients were included, with a mean age 71.7+/−13.3 years; 52.7% women; 93.2% DM2; Annual cost of GLT: 82.979 €,(281.9 €/patient/year). General practitioner (GP) originated 32.3% of the treatments (17.7% of the costs). Annual average expenditure was significantly higher in DM1 patients, patients on treatment with triple therapy and patients controlled by an endocrinologist in a reference hospital. In the multiple linear regression the variables that explained the variation in the cost were the type of Diabetes mellitus ( P<0.0001), prescription by hospital endocrinologist ( p=0,002), number of glucose lowering drugs( P<0.0001), diabetic retinopathy( P: 0.019) and chronic renal failure ( P: 0.027). These variables explained 44.5% of the annual cost variation of the GLT (R 2:0.445). Conclusions There is a wide variation in the costs arising from GLT of our diabetic patients. We conclude, it is essential to improve coordination between levels of care, encourage the design and use of clinical guidelines to achieve more efficient control of our patients.