The impact of hypoglycemia on healthcare costs: a modeling study from Chile

ABSTRACT

Background

This study aimed to estimate the expected cost of hypoglycemia in Diabetes Mellitus type-2 patients receiving hypoglycemic treatment in Chile and to explore the effect of the potential reduction of hypoglycemia over the total cost incurred by its public health system.

Research design and methods

A cost analysis was carried out based on a state transition mathematical model. The model used microsimulation with data from the National Health Survey 2016–2017 in Chile. Costs included follow-up, in-hospital and ambulatory care. Separate analysis was conducted for patients treated with insulin, or sulfonylurea.

Results

The annual expected total cost of hypoglycemia estimated for the Chilean public system was USD 288,922,523 (USD 273 per patient). The subgroup treated with insulin reached USD 353 per patient whereas the sulfonylurea subgroup was USD 217 per patient. The analysis revealed that for every 1% reduction of the incidence rate of severe hypoglycemia the cost is reduced 0.79% in total, 0.59% for the insulin subgroup, and 0.95% for the sulfonylurea subgroup.

Conclusions

The cost of hypoglycemia represents a high proportion of the public health budget in Chile, being similar to those resources allocated to provide coverage of diabetic treatments through its universal health benefit plan.

Abbreviations

DM2: type 2 diabetes mellitus; RR: relative risk; ENS: national health survey in Chile

KEYWORDS:

• Type 2 diabetes
• cost analysis
• hypoglycemia
• chile

Author contribution

Conceived and designed the experiments: CB ME. Performed the experiments: CB. Analyzed the data: CB ME. Contributed reagents/materials/analysis tools: CB ME. Wrote the paper: NE ME BC. Validation of data: CB ME. Model Adaptation: CB ME.

Declaration of interest

Investigators have realized this study in the context of their salary condition paid by the university and no further incentives were provided for this study. CB declares to have received honorarium from different pharmaceutical companies for educational services. ME has received compensation from diverse pharmaceutical companies for training on economic evaluation and prioritization in healthcare.The participation of ME in this project was made under the terms of Project FONDECYT ANID Nº 11190780. BC declares no conflict of interest. NE declares no conflict of interest. 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.

Reviewers Disclosure

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Data Availability Statement

The data that support the findings of this study are available in National Health Survey 2016-2017 at https://www.minsal.cl/wp-content/uploads/2017/11/ENS-2016-17_PRIMEROS-RESULTADOS.pdf reference number [2]. These data were derived from the following resources available in the public domain: http://epi.minsal.cl/encuestas-poblacionales/. All figures and tables are original.

Additional information

Funding

This study was funded by Novo Nordisk Chile commissioned to Pontificia Universidad Católica (Santiago, Chile) under strict independence agreement.