Healthcare costs among adults with type 2 diabetes initiating saxagliptin or linagliptin: a US-based claims analysis

Abstract

Objective: To compare healthcare costs of adults with type 2 diabetes (T2D) after initiation of saxagliptin or linagliptin, two antidiabetic medications in the dipeptidyl peptidase-4 inhibitor medication class.

Methods: Patients with T2D who were at least 18 years old and initiated saxagliptin or linagliptin (index date) between 1 June 2011 and 30 June 2014 were identified in the MarketScan Commercial and Medicare Supplemental Databases. All-cause healthcare costs and diabetes-related costs (T2D diagnosis on a medical claim and/or an antidiabetic medication claim) were measured in the 1 year follow-up period. Saxagliptin and linagliptin initiators were matched using propensity score methods. Cost ratios (CRs) and predicted costs were estimated from generalized linear models and recycled predictions.

Results: There were 34,560 saxagliptin initiators and 18,175 linagliptin initiators identified (mean ages 57 and 59; 55% and 56% male, respectively). Before matching, saxagliptin initiators had significantly lower all-cause total healthcare costs than linagliptin initiators (mean = $15,335 [SD $28,923] vs. mean = $20,069 [SD $48,541], p < .001) and significantly lower diabetes-related total healthcare costs (mean = $6109 [SD $13,851] vs. mean = $7393 [SD $26,041], p < .001). In matched analyses (n = 16,069 per cohort), saxagliptin initiators had lower all-cause follow-up costs than linagliptin initiators (CR = 0.953, 95% CI = 0.932–0.974, p < .001; predicted costs = $17,211 vs. $18,068). There was no significant difference in diabetes-related total costs after matching; however, diabetes-related medical costs were significantly lower for saxagliptin initiators (CR = 0.959, 95% CI = 0.927–0.993, p = 0.017; predicted costs = $3989 vs. $4159).

Conclusions: Adult patients with T2D initiating treatment with saxagliptin had lower total all-cause healthcare costs and diabetes-related medical costs over 1 year compared with patients initiating treatment with linagliptin.

Keywords:

• Type 2 diabetes mellitus
• dipeptidyl peptidase-4 inhibitor
• healthcare costs
• health expenditures

Transparency

Declaration of funding

This study was funded by AstraZeneca, Wilmington, DE, USA.

Author contributions: A.M.K. and J.J.S. were involved in the conception and design of the study. All authors were involved in the analysis and interpretation of the data and all authors were involved in drafting of the paper and revising it critically for intellectual content. All authors approved of the final version of this manuscript and agree to be accountable for all aspects of the work.

Declaration of financial/other relationships

T.P. has disclosed that she is an employee of AstraZeneca. S.F. and J.J.S. have disclosed that they were employees of AstraZeneca at the time this analysis was conducted. A.M.K., M.A.B., B.M. and D.M.S. have disclosed that they are employees of Truven Health Analytics which received funding from AstraZeneca to conduct this analysis. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

CMRO peer reviewers on this manuscript have no relevant financial or other relationships to disclose.