![Sample our Food Science & Technology journals, sign in here to start your access, latest two full volumes FREE to you for 14 days]({"type":"image" , "src" : "/sda/5936/TOC-Subject-Sample-2021-Food-Science-Technology.jpg"})
ABSTRACT
The goal of this study was to calculate and compare the direct medical cost of diabetes and its complications for insulin treated patients from the perspective of the health insurance fund. In a combined prospective and retrospective observational study with duration of 6 months, 433 patients were randomly selected and were divided into 3 subgroups: 153 patients on insulin analogues, 115 on human insulin, and 165 on a combination of insulin and oral antidiabetic drugs (OAD). The cost of therapy for each group of patients was calculated as a sum of the units of health care resources used and their individual price. The average cost attributable to each individual patient was calculated by dividing the total cost by the number of patients. A second step analysis was performed in a hospitalized subgroup of patients during the period.
Insulin analogues, due to their higher prices, are with the highest cost per 6-month therapy (652.12 BGN), closely followed by the combination therapy cost (479.54 BGN) in case just insulin therapy is considered. In contrast, the cost of hospitalizations due to diabetes was found to be lowest in the group of patients on insulin analogues, followed by that for patients on a combination of insulin plus OAD therapy, and highest for the group on human insulin therapy. The main cost drivers are the medications for diabetes (46 % of the total cost on average), outpatient medications for diabetes complications (27%), and hospitalization due to diabetes (14 %). These cost components account for 87% of the total cost. When adding the cost of hospitalizations due to diabetes complications, 96 % of the total cost is reached.
A selection of the main treatment pattern linked to insulin/insulin analogue +/- OAD administration depends on individual patients characteristics (type of DM, Hb1Ac, age, complications etc.) as well as healthcare system organization (e.g. sequential therapy). It explains the cost structure differences between the heterogenic groups analysed. Intensification of the insulin therapy seems to be cost neutral from the total costs perspective.
