The burden of illness of hypertension and comorbid diabetes

ABSTRACT

Objective: To compare the impact of comorbid hypertension and diabetes on resource utilization and costs compared to diabetes mellitus (DM) or hypertension (HTN) alone.

Methods: A retrospective claims analysis assessed economic trends in patients without pre-existing CV disease in three cohorts: newly-treated HTN-only, DM-only, and newly-treated HTN and DM (comorbid cohort). Total, CV-specific, and DM-specific costs measured for up to 24 months were classified into five categories: inpatient, outpatient, emergency department (ED), physician, and other medical. Costs were compared using linear regression, controlling for age, gender, comorbidities, and non-CV- or DM-related prescriptions at baseline.

Results: The comorbid cohort had the highest inpatient (%1920), outpatient (%1664), ED (%126), other medical (%218), and pharmacy costs (%2388), plus significantly higher CV- and DM-specific costs. At 24 months, HTN-related costs for the HTN cohort equaled %1604, while DM-related costs for the DM cohort totaled %2023. Comparatively, HTN-related costs for patients with HTNT + DM were %2678 while DM-related costs were %3094, being over %1000 and %1800 more than each individual cohort, respectively. A post-hoc analysis of CV events found the comorbid cohort had significantly more myocardial infarctions (MIs) and acute ischemic events than did the HTN-only cohort.

Conclusion: Higher cost and resource utilization is associated with comorbid HTN and DM. Higher average disease-specific costs over 24 months indicate an intensity of care for patients with comorbid disease that is beyond that of simply managing an additional disease state. Study limitations include patient selection biases, which are possible with any administrative commercial database analysis.

Key Words::

• Diabetes mellitus
• Economic patterns
• Hypertension
• Resource utilization

Acknowledgment

Declaration of interest: This study was financially supported by GlaxoSmithKline. Freelance medical writer Beatriz Manzor Mitrzyk assisted with the development of this manuscript.