Drug usage patterns and treatment costs in newly-diagnosed type 2 diabetes mellitus cases, 2007 vs 2012: findings from a large US healthcare claims database analysis

Figures & data

Table 1. Demographic characteristics of newly-diagnosed type 2 diabetes mellitus populations, 2007 vs 2012.

	2007	2012
Total database population	15,065,725	24,517,156
All patients with T2DM, n	1,237,451	2,040,901
Newly-diagnosed T2DM, n	152,272	147,011
% of all T2DM	12.3	7.2
% of all at-risk patients	1.1	0.65
Newly-diagnosed type 2 diabetes mellitus population
Age, years
Mean (SD)	57.7 (13.4)	54.8 (13.0)
Range	18–106	18–103
Sex, n (%)
Female	75,191 (49.4)	71,042 (48.3)
Male	77,081 (50.6)	75,969 (51.7)
Region of US, n (%)
Central	45,250 (29.7)	35,556 (24.2)
Northeast	15,988 (10.5)	21,666 (14.7)
South	67,903 (44.6)	60,279 (41.0)
West	22,555 (14.8)	27,335 (18.6)
Unknown	576 (0.4)	2175 (1.5)
Insurance, n (%)
Commercial	113,714 (74.7)	122,178 (83.1)
Medicare	38,558 (25.3)	24,833 (16.9)

SD, standard deviation; T2DM, type 2 diabetes mellitus.

Figure 1. Overall distribution of drug prescriptions among newly-diagnosed patients, 2007 and 2012. GLP1, glucagon-like peptide-1 agonist; OAD, oral anti-diabetic drug.

Table 2. Distribution of drug classes prescribed for patients with newly-diagnosed type 2 diabetes mellitus, 2007 vs 2012.

	2007		2012
	n	%	n	%
n	152,272	100	147,011	100
No drugs	73,574	48.3	53,182	36.2
OADs only
Any OAD	70,425	46.2	83,428	56.7
1 OAD	47,968	31.5	64,344	43.8
2 OADs	18,038	11.8	16,522	11.2
3 OADs	4,008	2.6	2,361	1.6
Insulin ± OADs	5,878	3.9	7,804	5.3
Insulin only	2,062	1.4	2,414	1.6
1 OAD	2,003	1.3	3,155	2.1
2 OADs	1,280	0.8	1,817	1.2
3 OADs	476	0.3	364	0.2

OAD, oral anti-diabetic drug.

Percentages reflect proportion of all newly-diagnosed patients with relevant claims in the given year.

Figure 2. Distribution of OAD use by number of different OADs represented in claims among newly-diagnosed patients, 2007 and 2012. OAD, oral anti-diabetic drug. Percentages reflect the proportion of patients within the category. Percentages for patients using four or more OADs are not reflected graphically: OADs only, 2007 (0.6%), 2012 (0.2%); Insulin + OADs, 2007 (1.0%), 2012 (0.7%).

Figure 3. Distribution of OAD use by specific drugs/classes among newly-diagnosed type 2 diabetes mellitus patients using (a) OADs only or (b) insulin plus OADs, 2007 vs 2012. DPP-IV, dipeptidyl peptidase-4 inhibitor; MET, metformin; OAD, oral anti-diabetic drug; SU, sulfonylurea; TZD, thiazolidinedione. Percentages reflect the proportion of patients within the category. Percentages for patients using ‘Other’ OADs are not reflected graphically: 1 ‘Other’ OAD only, 2007 (3.9%), 2012 (2.4%); 2 ‘Other’ OADs only (for ‘Other’ OAD combinations), 2007 (4.0%), 2012 (3.3%); Insulin + 1 ‘Other’ OAD only, 2007 (6.0%), 2012 (5.9%); Insulin + 2 ‘Other’ OADs, 2007 (7.4%), 2012 (5.8%).

Table 3. Prescription claim detail for all newly-diagnosed type 2 diabetes mellitus patients, 2007 and 2012.

	2007(n = 152,272)		2012(n = 147,011)
	n	%	n	%
OADs only	70,425	46.2	83,428	56.7
1 OAD only	47,968	31.5	64,344	43.8
MET	35,837	23.5	58,455	39.8
SU	6766	4.4	3,964	2.7
TZD	3507	2.3	358	0.2
2 OADs only	18,038	11.8	16,522	11.2
MET, SU	8702	5.7	9,434	6.4
MET, DPP-IV	2003	1.3	5,638	6.8
MET, TZD	5396	3.5	796	1.0
SU, TZD	1214	0.8	107	0.1
Total insulin ± OADs	5878	3.9	7,804	5.3
Insulin + 1 OAD	2003	1.3	3,155	2.1
MET	1110	0.7	2,512	1.7
SU	548	0.4	425	0.3
TZD	224	0.1	33	0.02
Insulin + 2 OADs	1280	0.8	1,817	1.2
MET, SU	625	0.4	1,018	0.7
MET, DPP-IV	84	0.1	596	0.4
MET, TZD	344	0.2	91	0.1
SU, TZD	132	0.1	7	0.005

DPP-IV, dipeptidyl peptidase-IV inhibitor; MET, metformin; OAD, oral anti-diabetic drug; SU, sulfonylurea; TZD, thiazolidinedione.

Percentages reflect the proportion within the newly-diagnosed T2DM population per year.

Table 4. Annual healthcare costs per patient with newly-diagnosed type 2 diabetes mellitus, 2007 vs 2012.

	Total annual costs per patient, US$^a
	2007 (n = 152,272)	2012 (n = 147,011)	Difference	% Change
Inpatient services	4613	5013	400
Inpatient ER	244	548	303
Total inpatient	4857	5560	703	+14.5
Outpatient^b	5668	6460	792
Outpatient ER	549	880	330
Total outpatient	6218	7339	1122	+18.0
Total services	11,075	12,899	1825	+16.5
Diabetes drugs	226	231	5
Total drugs^c	2669	2276	–393	−14.7
Total costs^d	13,744	15,175	1432	+10.4

ER, emergency room.

a Adjusted to 2012 dollars.

b Outpatient services were used by 99.7% and 99.8% of all patients in 2007 and 2012, respectively.

c Total drugs include Diabetes drugs.

d Total services plus Total drugs .

Table 5. Inpatient and outpatient utilization patterns and cost details, 2007 vs 2012.

		2007	2012	Difference
General inpatient services
Number of utilizers (% of type 2 diabetes mellitus population)		24,456 (16.1)	20,691 (14.1)	−3765
Total number of days		214,749	189,793	−24,956
Mean length of stay, days per utilizer		8.78	9.17	0.39
Total cost		$702,426,739	$736,903,596	$34,476,857
Cost/utilizer/day		$3271	$3883	$612
Cost/utilizer		$28,722	$35,615	$6893
Inpatient ER
Number of utilizers (% of type 2 diabetes mellitus population)		1877 (1.2)	3482 (2.4)	1605
Total number of days		10,788	23,647	12,859
Mean length of stay, days per utilizer		5.75	6.79	1.04
Total cost		$37,174,135	$80,489,363	$43,315,228
Cost/utilizer/day		$3446	$3404	−$42
Cost/utilizer		$19,805	$23,116	$3311
General outpatient services
Number of utilizers (% of type 2 diabetes mellitus population)		151,822 (99.7)	146,707 (99.8)	−5115
Total cost		$863,114,059	$949,654,689	$86,504,630
Cost/utilizer		$5684	$6473	$789
Outpatient ER
Number of utilizers (% of type 2 diabetes mellitus population)		39,407 (25.9)	39,571 (26.9)	344
Total cost		$83,668,555	$129,318,735	$45,650,180
Cost/utilizer		$2123	$3268	$1145

ER, emergency room.