Longitudinal analysis of atherosclerotic cardiovascular disease risk and healthcare costs in newly diagnosed type 2 diabetes in a real-world setting

J Diabetes Complications. 2020 May;34(5):107500. doi: 10.1016/j.jdiacomp.2019.107500. Epub 2019 Dec 2.

Abstract

Aims: To assess longitudinal risk for atherosclerotic cardiovascular disease (ASCVD) and cost of healthcare resource utilization over 9 years in patients with or without newly diagnosed type 2 diabetes (T2DM) who had no ASCVD at baseline.

Methods: This retrospective, longitudinal analysis of a large, nationwide US administrative claims database compared adults with newly diagnosed T2DM (n = 22,468) and a propensity score matched non-T2DM cohort (n = 22,468). Longitudinal risk of ASCVD and total annual healthcare costs were determined. Subgroup analysis was conducted for 3 age categories: 18-44, 45-64, and 65+ years.

Results: From 2006 to 2015, ASCVD was identified in a significantly greater percentage of patients in the T2DM versus non-T2DM cohort (43.2% vs 32.3%; Hazard ratio [HR] = 1.45, P < 0.001). Total annual healthcare cost was markedly higher in T2DM versus non-T2DM cohorts (48.4% higher at year 9). The differences between cohorts were most pronounced in patients aged 18-44 years.

Conclusions: This 9-year claims-based retrospective, longitudinal analysis showed a higher risk of ASCVD and higher healthcare costs in newly diagnosed T2DM patients versus those without T2DM, with highest relative risk and cost differences observed in younger patients.

Keywords: Atherosclerotic cardiovascular disease; Claims; Cost; Longitudinal; Risk; Type 2 diabetes mellitus.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Atherosclerosis / economics
  • Atherosclerosis / epidemiology*
  • Cardiovascular Diseases / economics
  • Cardiovascular Diseases / epidemiology
  • Databases, Factual
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetes Mellitus, Type 2 / economics
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Female
  • Health Care Costs / statistics & numerical data
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care / statistics & numerical data
  • Propensity Score
  • Retrospective Studies
  • Risk
  • United States / epidemiology
  • Young Adult