Hospital costs associated with adverse events in people with diabetes in the UK.
Keng MJ., Leal J., Bowman L., Armitage J., Mihaylova B., ASCEND Study Collaborative Group None.
AIMS: Robust cost estimates are required to inform economic analysis of diabetes treatments. We estimate the annual hospital costs associated with a range of adverse events for people with diabetes in the UK. METHODS: Annual hospital costs (2019/20 GBP£) were derived from 15436 ASCEND participants between 2005 and 2017 (120,420 person-years). The annual hospital costs associated with cardiovascular events (myocardial infarction, coronary revascularisation, transient ischaemic attack (TIA), ischaemic stroke, heart failure), bleeding (gastrointestinal (GI) bleed, intracranial haemorrhage, other major bleed), cancer (GI tract cancer, non-GI tract cancer), end-stage renal disease (ESRD), lower limb amputation and death (vascular, non-vascular) were estimated using generalised linear model following adjustment for participants' socio-demographic and clinical factors. RESULTS: In the year of event, ESRD was associated with the largest increase in annual hospital cost (£20954), followed by lower limb amputation (£17887), intracranial haemorrhage (£12080), GI tract cancer (£10160), coronary revascularisation (£8531 if urgent; £8302 if non-urgent), heart failure (£8319), non-GI tract cancer (£7409), ischaemic stroke (£7170), GI bleed (£5557), myocardial infarction (£4913), other major bleed (£3825), and TIA (£1523). In subsequent years, most adverse events were associated with lasting but smaller increases in hospital cost, except for ESRD where the additional cost remained high (£20090). CONCLUSION: Our study provides robust estimates of annual hospital costs associated with a range of adverse events in people with diabetes which can inform future cost-effectiveness analyses of diabetes interventions. It also highlights the potential cost savings that could be derived from prevention of these costly complications. This article is protected by copyright. All rights reserved.