Comparison of healthcare resource utilization and costs in patients with type 2 diabetes initiating dapagliflozin versus sitagliptin

Diabetes Obes Metab. 2019 Feb;21(2):227-233. doi: 10.1111/dom.13502. Epub 2018 Sep 10.

Abstract

Aims: To compare healthcare costs and utilization in patients with type 2 diabetes (T2D) who initiated dapagliflozin (DAPA) with costs and utilization in those who initiated sitagliptin (SITA) in a real-world setting.

Materials and methods: This was a retrospective study of health plan enrollees in two US commercial claims databases or Medicare Part D. The study population comprised adult patients with T2D who initiated DAPA or SITA between January 1, 2014 and April 30, 2015. DAPA and SITA initiators were propensity-score-matched, and healthcare utilization and costs during the 1-year follow-up period were compared. Analyses were conducted separately for patients with evidence of oral antidiabetic drug (OAD) monotherapy use at baseline.

Results: A total of 2722 patients were included in each matched cohort. Follow-up unadjusted all-cause costs ($16 065 and $17 281; P = 0.135) and diabetes-related costs ($9697 and $9354; P = 0.539) were similar in the DAPA and SITA cohorts. Higher office and outpatient visit costs in the SITA group were offset by higher pharmacy costs in the DAPA group. In the subgroup of 1804 patients with OAD monotherapy use at baseline, patients in the SITA group had higher total all-cause costs compared with those in the DAPA group ($14 884 vs. $12 353; P = 0.026).

Conclusion: Patients who initiated DAPA or SITA had similar all-cause and diabetes-related healthcare costs over 1 year of follow-up. In the subgroup of patients treated with OAD monotherapy at baseline (84% metformin monotherapy), those who initiated DAPA as add-on therapy had lower costs than patients who added SITA.

Keywords: costs; dapagliflozin; sitagliptin; utilization.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Benzhydryl Compounds / economics
  • Benzhydryl Compounds / therapeutic use*
  • Cohort Studies
  • Databases, Factual
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / economics*
  • Diabetes Mellitus, Type 2 / epidemiology
  • Female
  • Glucosides / economics
  • Glucosides / therapeutic use*
  • Health Care Costs* / statistics & numerical data
  • Health Resources* / economics
  • Health Resources* / statistics & numerical data
  • Humans
  • Insurance Claim Review
  • Male
  • Medicare Part D / economics
  • Medicare Part D / statistics & numerical data
  • Metformin / economics
  • Metformin / therapeutic use
  • Middle Aged
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Retrospective Studies
  • Sitagliptin Phosphate / economics
  • Sitagliptin Phosphate / therapeutic use*
  • United States / epidemiology

Substances

  • Benzhydryl Compounds
  • Glucosides
  • dapagliflozin
  • Metformin
  • Sitagliptin Phosphate