Healthcare resource utilization and costs assessment of type 2 diabetes patients initiating exenatide BID or glargine: a retrospective database analysis

Abstract

Objective:

To examine resource utilization and healthcare costs associated with the use of exenatide versus glargine in type 2 diabetes (T2D) patients.

Methods:

A retrospective analysis comprised of patients with T2D initiating exenatide (n = 7,255) or glargine (n = 2,819) between 04/01/2005 and 06/30/2007. Propensity score matching was used (2,506 matched pairs) to control for baseline demographic, clinical, resource use, and cost variables to balance treatment groups. Mean medical costs and other cost components were estimated using nonparametric bootstrapping.

Results:

Exenatide-treated patients had 19% lower likelihood of all-cause hospitalizations (odds ratio [OR]: 0.81, p = 0.009) compared to glargine-treated patients.

Exenatide-treated patients had significantly lower total medical costs of $2,597 (p = 0.008). Exenatide-treated patients had significantly lower inpatient costs of $1,968 (p = 0.004) and outpatient costs of $1,324 (p = 0.011), but higher prescription costs of $706 (p < 0.001). Exenatide-treated patients further incurred lower hospitalization costs of $1,910 (p = 0.005) and physician office visit costs of $608 (p = 0.008).

Key limitations:

Lack of availability of clinical measures including duration of diabetes, severity of T2D and lack of control for unmeasured confounding.

Conclusions:

Patients initiating exenatide treatment had significantly lower healthcare resource utilization and total medical costs. Cost offsets were observed in inpatient and outpatient costs despite higher prescription costs.

Key words::

• Exenatide
• Healthcare costs
• Insulin glargine
• Resource use

Transparency

Declaration of funding:

This study was funded by Eli Lilly and Company. Eli Lilly and Company contracted the technical writing of this manuscript with i3 Statprobe.

Declaration of financial relationships:

M.P. and A.Z. are employees and stockholders of Eli Lilly and Company. T.S. is employed by MedFocus LLC and inventive Clinical Solutions LLC. L.S. is an employee of Tulane University and works as a consultant for Eli Lilly and Company.

Acknowledgments:

Eli Lilly and Company contracted the technical writing of this manuscript with i3 Statprobe. The authors thank Johnna Anderson for assistance in data analysis, Eli Lilly and Company and Lilly USA, Dr Jarrett Coffindaffer and Ms Teri Tucker, i3 Statprobe employees, for writing and editorial assistance, and John H. Holcombe, MD and Mark L. Hartman, MD, Eli Lilly and Company and Lilly USA, for reviewing and commenting on the manuscript.