ABSTRACT
Objectives: To compare health care costs among patients with type 2 diabetes mellitus (T2DM) who added a new oral anti-diabetes drug (OAD) to an initial regimen with those who up-titrated their initial OAD.
Methods: Insurance claims data were obtained from 94 health plans for patients aged ≥18 years with ICD-9-CM diagnosis of T2DM during the period Jan. 1, 2001-June 30, 2007, and a newly prescribed metformin or sulfonylurea monotherapy. Patients were followed after initiating monotherapy to identify occurrence of first-treatment modification (addition or up-titration). Health care costs were analyzed during 360 days after first treatment modification. Subgroup analyses included comparison of addition cohort with two titration subgroups: 1) titration up to or below intermediate doses and 2) titration to beyond intermediate doses.
Results: During the post-treatment modification period, all-cause medication costs were 9% higher (p <0.0001), while inpatient costs were 14% lower for the addition cohort (p<0.008) as compared to the up-titration cohort. The total risk-adjusted health care costs were slightly lower but statistically insignificant for the addition cohort compared to the up-titration cohort (ratio of cost = 0.99; p = 0.052). These costs patterns remained similar for both the up-titration subgroups.
Conclusions: While addition of another OAD to the initial OAD regimen may result in higher medication costs, the lower inpatient costs and overall offset in the subsequent total costs may indicate clinical benefits with the add-on treatment. When appropriate and clinically beneficial, physicians may want to consider adding an OAD rather than up-titrating the current OAD, particularly beyond intermediate dose levels.
More like this
- Hemoglobin A1c Outcomes and Health Care Resource Use In Type 2 Diabetes Mellitus Patients Treated With Combination Oral Antidiabetic Drugs Through Step Therapy And Loose-Dose and Fixed-Dose Combinations
- The Cost-Effectiveness of Omega-3 Supplements For Prevention of Secondary Coronary Events
- Healthcare Chief Medical Officer Forum
- Pharmaceutical and Biotech Clinical Quality Assurance Conference
- Can Amylin Analogue Lead To Better Diabetes Control?

Paul Lendner ist ein praktizierender Experte im Bereich Gesundheit, Medizin und Fitness. Er schreibt bereits seit über 5 Jahren für das Managed Care Mag. Mit seinen Artikeln, die einen einzigartigen Expertenstatus nachweisen, liefert er unseren Lesern nicht nur Mehrwert, sondern auch Hilfestellung bei ihren Problemen.