Costs and Treatment Pathways for Type 2 Diabetes in the UK: A Mastermind Cohort Study

Peter Eibich; Amelia Green; Andrew T. Hattersley; Christopher Jennison; Mike Lonergan; Ewan R Pearson; Alastair M. Gray

doi:10.1007/s13300-017-0296-x

Costs and Treatment Pathways for Type 2 Diabetes in the UK: A Mastermind Cohort Study

Peter Eibich (Lead / Corresponding author), Amelia Green, Andrew T. Hattersley, Christopher Jennison, Mike Lonergan, Ewan R Pearson, Alastair M. Gray

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Abstract

Introduction: Medication therapy for type 2 diabetes has become increasingly complex, and there are few reliable data on the current state of clinical practice. We report treatment pathways and associated costs of medication therapy for people with type 2 diabetes in the UK, their variability and changes over time.

Methods: Prescription and biomarker data for 7159 people with type 2 diabetes were extracted from the GoDARTS cohort study, covering the period 1989-2013. Average follow-up was 10 years. Individuals were prescribed on average 2.4 (SD: 1.2) drugs with average annual costs of £241. We calculated summary statistics for first- and second-line therapies. Linear regression models were used to estimate associations between therapy characteristics and baseline patient characteristics.

Results: Average time from diagnosis to first prescription was 3 years (SD: 4.0 years). Almost all first-line therapy (98%) was monotherapy, with average annual cost of £83 (SD: £204) for 3.8 (SD: 3.5) years. Second-line therapy was initiated in 73% of all individuals, at an average annual cost of £219 (SD: £305). Therapies involving insulin were markedly more expensive than other common therapies. Baseline HbA1c was unrelated to future therapy costs, but higher average HbA1c levels over time were associated with higher costs.

Conclusions: Medication therapy has undergone substantial changes during the period covered in this study. For example, therapy is initiated earlier and is less expensive than in the past. The data provided in this study will prove useful for future modelling studies, e.g. of stratified treatment approaches.

Original language	English
Pages (from-to)	1031-1045
Number of pages	15
Journal	Diabetes Therapy
Volume	8
Issue number	5
Early online date	6 Sept 2017
DOIs	https://doi.org/10.1007/s13300-017-0296-x
Publication status	Published - Oct 2017

Keywords

Costs
First-line therapy
Medication therapy
Second-line therapy
Therapy initiation
Type 2 diabetes
UK

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Open Access. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Final published version, 753 KBLicence: CC BY-NC

Stratified Medicine in Type 2 Diabetes: Insights from the Study of Drug Response (New Investigator Award)
Pearson, E. (Investigator)
16/02/15 → 15/08/21
Project: Research

Cite this

@article{81ec14370ede4e2198eaf87a9c393b87,

title = "Costs and Treatment Pathways for Type 2 Diabetes in the UK: A Mastermind Cohort Study",

abstract = "Introduction: Medication therapy for type 2 diabetes has become increasingly complex, and there are few reliable data on the current state of clinical practice. We report treatment pathways and associated costs of medication therapy for people with type 2 diabetes in the UK, their variability and changes over time.Methods: Prescription and biomarker data for 7159 people with type 2 diabetes were extracted from the GoDARTS cohort study, covering the period 1989-2013. Average follow-up was 10 years. Individuals were prescribed on average 2.4 (SD: 1.2) drugs with average annual costs of £241. We calculated summary statistics for first- and second-line therapies. Linear regression models were used to estimate associations between therapy characteristics and baseline patient characteristics.Results: Average time from diagnosis to first prescription was 3 years (SD: 4.0 years). Almost all first-line therapy (98%) was monotherapy, with average annual cost of £83 (SD: £204) for 3.8 (SD: 3.5) years. Second-line therapy was initiated in 73% of all individuals, at an average annual cost of £219 (SD: £305). Therapies involving insulin were markedly more expensive than other common therapies. Baseline HbA1c was unrelated to future therapy costs, but higher average HbA1c levels over time were associated with higher costs.Conclusions: Medication therapy has undergone substantial changes during the period covered in this study. For example, therapy is initiated earlier and is less expensive than in the past. The data provided in this study will prove useful for future modelling studies, e.g. of stratified treatment approaches.",

keywords = "Costs, First-line therapy, Medication therapy, Second-line therapy, Therapy initiation, Type 2 diabetes, UK",

author = "Peter Eibich and Amelia Green and Hattersley, {Andrew T.} and Christopher Jennison and Mike Lonergan and Pearson, {Ewan R} and Gray, {Alastair M.}",

note = "The authors gratefully acknowledge funding by the Medical Research Council (MRC) and the Association of the British Pharma Industry (ABPI) for “Mastermind” (MRC APBI STratification and Extreme Response Mechanism IN Diabetes–MASTERMIND. Grant Ref.: MRIK005707/1). ERP holds Wellcome Trust New Investigator award 102820/Z/13/Z. GoDARTS was funded by the Wellcome Trust as the Wellcome Trust Type 2 diabetes case control study. The funders were not involved in any way in the research reported in this article. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this manuscript, take responsibility for the integrity of the work as a whole and have given final approval to the version to be published.",

year = "2017",

month = oct,

doi = "10.1007/s13300-017-0296-x",

language = "English",

volume = "8",

pages = "1031--1045",

journal = "Diabetes Therapy",

issn = "1869-6953",

publisher = "Springer Publishing Company",

number = "5",

}

TY - JOUR

T1 - Costs and Treatment Pathways for Type 2 Diabetes in the UK

T2 - A Mastermind Cohort Study

AU - Eibich, Peter

AU - Green, Amelia

AU - Hattersley, Andrew T.

AU - Jennison, Christopher

AU - Lonergan, Mike

AU - Pearson, Ewan R

AU - Gray, Alastair M.

N1 - The authors gratefully acknowledge funding by the Medical Research Council (MRC) and the Association of the British Pharma Industry (ABPI) for “Mastermind” (MRC APBI STratification and Extreme Response Mechanism IN Diabetes–MASTERMIND. Grant Ref.: MRIK005707/1). ERP holds Wellcome Trust New Investigator award 102820/Z/13/Z. GoDARTS was funded by the Wellcome Trust as the Wellcome Trust Type 2 diabetes case control study. The funders were not involved in any way in the research reported in this article. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this manuscript, take responsibility for the integrity of the work as a whole and have given final approval to the version to be published.

PY - 2017/10

Y1 - 2017/10

N2 - Introduction: Medication therapy for type 2 diabetes has become increasingly complex, and there are few reliable data on the current state of clinical practice. We report treatment pathways and associated costs of medication therapy for people with type 2 diabetes in the UK, their variability and changes over time.Methods: Prescription and biomarker data for 7159 people with type 2 diabetes were extracted from the GoDARTS cohort study, covering the period 1989-2013. Average follow-up was 10 years. Individuals were prescribed on average 2.4 (SD: 1.2) drugs with average annual costs of £241. We calculated summary statistics for first- and second-line therapies. Linear regression models were used to estimate associations between therapy characteristics and baseline patient characteristics.Results: Average time from diagnosis to first prescription was 3 years (SD: 4.0 years). Almost all first-line therapy (98%) was monotherapy, with average annual cost of £83 (SD: £204) for 3.8 (SD: 3.5) years. Second-line therapy was initiated in 73% of all individuals, at an average annual cost of £219 (SD: £305). Therapies involving insulin were markedly more expensive than other common therapies. Baseline HbA1c was unrelated to future therapy costs, but higher average HbA1c levels over time were associated with higher costs.Conclusions: Medication therapy has undergone substantial changes during the period covered in this study. For example, therapy is initiated earlier and is less expensive than in the past. The data provided in this study will prove useful for future modelling studies, e.g. of stratified treatment approaches.

AB - Introduction: Medication therapy for type 2 diabetes has become increasingly complex, and there are few reliable data on the current state of clinical practice. We report treatment pathways and associated costs of medication therapy for people with type 2 diabetes in the UK, their variability and changes over time.Methods: Prescription and biomarker data for 7159 people with type 2 diabetes were extracted from the GoDARTS cohort study, covering the period 1989-2013. Average follow-up was 10 years. Individuals were prescribed on average 2.4 (SD: 1.2) drugs with average annual costs of £241. We calculated summary statistics for first- and second-line therapies. Linear regression models were used to estimate associations between therapy characteristics and baseline patient characteristics.Results: Average time from diagnosis to first prescription was 3 years (SD: 4.0 years). Almost all first-line therapy (98%) was monotherapy, with average annual cost of £83 (SD: £204) for 3.8 (SD: 3.5) years. Second-line therapy was initiated in 73% of all individuals, at an average annual cost of £219 (SD: £305). Therapies involving insulin were markedly more expensive than other common therapies. Baseline HbA1c was unrelated to future therapy costs, but higher average HbA1c levels over time were associated with higher costs.Conclusions: Medication therapy has undergone substantial changes during the period covered in this study. For example, therapy is initiated earlier and is less expensive than in the past. The data provided in this study will prove useful for future modelling studies, e.g. of stratified treatment approaches.

KW - Costs

KW - First-line therapy

KW - Medication therapy

KW - Second-line therapy

KW - Therapy initiation

KW - Type 2 diabetes

KW - UK

U2 - 10.1007/s13300-017-0296-x

DO - 10.1007/s13300-017-0296-x

M3 - Article

C2 - 28879529

SN - 1869-6953

VL - 8

SP - 1031

EP - 1045

JO - Diabetes Therapy

JF - Diabetes Therapy

IS - 5

ER -

Costs and Treatment Pathways for Type 2 Diabetes in the UK: A Mastermind Cohort Study

Abstract

Keywords

UN SDGs

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Projects

Stratified Medicine in Type 2 Diabetes: Insights from the Study of Drug Response (New Investigator Award)

Cite this