Dapagliflozin vs non‐SGLT‐2i treatment is associated with lower healthcare costs in type 2 diabetes patients similar to participants in the DECLARE‐TIMI 58 trial: A nationwide observational study

• Published in: Diabetes, obesity & metabolism obesity & metabolism, 2019-12, Vol.21 (12), p.2651-2659
• Main Authors: Norhammar, Anna, Bodegard, Johan, Nyström, Thomas, Thuresson, Marcus, Rikner, Klas, Nathanson, David, Eriksson, Jan W.
• Format: Article
• Language: English
• Subjects: Aged; Antidiabetics; Benzhydryl Compounds - economics; Benzhydryl Compounds - therapeutic use; Cardiovascular diseases; Diabetes; Diabetes mellitus (non-insulin dependent); 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; Hospital costs; Hospitalization - economics; Hospitalization - statistics & numerical data; Humans; Hypoglycemic Agents - economics; Hypoglycemic Agents - therapeutic use; Male; Medicin och hälsovetenskap; Middle Aged; Observational studies; Original; Patients; Population; Sodium; Sodium-glucose cotransporter; Sodium-Glucose Transporter 2 Inhibitors - economics; Sodium-Glucose Transporter 2 Inhibitors - therapeutic use; Sweden
• ISSN: 1462-8902; 1463-1326; 1463-1326
• DOI: 10.1111/dom.13852

Aims To investigate how the cardiovascular (CV) risk benefits of dapagliflozin translate into healthcare costs compared with other non‐sodium–glucose cotransporter‐2 inhibitor glucose‐lowering drugs (oGLDs) in a real‐world population with type 2 diabetes (T2D) that is similar to the population of the DECLARE‐TIMI 58 trial. Methods Patients initiating dapagliflozin or oGLDs between 2013 and 2016 in Swedish nationwide healthcare registries were included if they fulfilled inclusion and exclusion criteria of the DECLARE‐TIMI 58 trial (DECLARE‐like population). Propensity scores for the likelihood of dapagliflozin initiation were calculated, followed by 1:3 matching with initiators of oGLDs. Per‐patient cumulative costs for hospital healthcare (in‐ and outpatient) and for drugs were calculated from new initiation until end of follow‐up. Results A total of 24 828 patients initiated a new GLD; 6207 initiated dapagliflozin and 18 621 initiated an oGLD. After matching based on 96 clinical and healthcare cost variables, groups were balanced at baseline. Mean cumulative 30‐month healthcare cost per patient was similar in the dapagliflozin and oGLD groups ($11 807 and $11 906, respectively; difference, −$99; 95% CI, −$629, $483; P = 0.644). Initiation of dapagliflozin rather than an oGLD was associated with significantly lower hospital costs (−$658; 95% CI, −$1169, −$108; P = 0.024) and significantly higher drug costs ($559; 95% CI, $471, $648; P