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- Title
Association Between Use of Thiazolidinediones and Costs of Heart Failure in Patients with Type 2 Diabetes.
- Authors
Delea, Thomas E.; Hagiwara, May; Plauschinat, Craig A.
- Abstract
Recently published outcomes trials have demonstrated extraglycemic effects with thiazolidinediones (TZDs), including an increased risk of heart failure (HF). Our objective was to evaluate the costs of HF-related care in patients with type 2 diabetes (T2D) receiving TZDs versus other oral antidiabetic drugs (OADs). We conducted a retrospective cohort study using a health insurance claims database. The sample included patients with T2D who received an OAD between 1/1/95 and 3/31/01. Each patient receiving a TZD was paired to a non-TZD patient based on propensity score. Patients with a diagnosis of HF or prescriptions for digoxin or diuretics in the year prior to index date were excluded. The primary measure of interest was the costs of all HF-related care over 36 mo. of follow-up, defined as the stun of plan payments for inpatient claims with a primary diagnosis of HF (ICD-9-CM 402.11, 402.91,428, 428.0, 428.1, 428.9), outpatient claims with a primary or secondary diagnosis of HF, and pharmacy claims for drugs commonly used to treat HF initiated on or after the date of 1st HF diagnosis. There were 10,880 patients included in the study (5,440 propensity-matched pairs of TZD and non-TZD patients). Over 36 mo. of follow-up, 126 TZD patients (2.3%) experienced HF, compared to 59 non-TZD patients (1.1%). Kaplan-Meier estimated risk of HF after 36 mo. was 8.8% and 4.5% in TZD and non-TZD patients, respectively. The total costs of HF-related care over 36 mo. were $129 greater (95%CI $39 to $239) in TZD patients vs. non-TZD patients ($212 vs $83) representing an increase of $3.58 per patient per mo. Costs of HF-related inpatient care over 36 mo. were $94 greater in TZD patients (95%CI $24 to $169). HF-related pharmacy costs were $31 greater in TZD patients, although the difference was not significant (95%CI -$5 to $101). Our results suggest that TZD use may increase HF costs in patients with T2D.
- Subjects
DRUG side effects; HYPOGLYCEMIC agents; HEART failure; PEOPLE with diabetes; TYPE 2 diabetes; DIGOXIN
- Publication
Diabetes, 2007, Vol 56, pA317
- ISSN
0012-1797
- Publication type
Article