Health care costs associated with escalation of drug treatment in type 2 diabetes mellitus

The cost of different intensities of therapy in HMO patients with type 2 di abetes mellitus was studied. Health care utilization data from 1995 were obtained for 12,200 registrants from the Kaiser Permanente Northwest Diabetes Registry who had type 2 diab etes mellitus. The data were used to determine costs associated with the es calation of antidiabetic therapies in persons with type 2 diabetes mellitus . The total annual costs (in 1993 dollars) associated with no drug therapy, a sulfonyl urea only, metformin, a sulfonylurea plus insulin, and insulin al one were $4400, $4187, $4838, $8856, and $7365, respectively Per patient to tal costs were higher for patients who had received antidiabetic therapy in 1995 or previously than for those who had not ($5303 versus $4365) and for patients who had received insulin therapy than for those who had not ($737 9 versus $4117). Macrovascular complications accounted for 62-89% of the co st associated with inpatient treatment of diabetes-related complications. The total cost of treating patients with type 2 diabetes mellitus at an HMO increased as antidiabetic therapies escalated.