Healthcare resource utilization and costs assessment of type 2 diabetes patients initiating exenatide BID or glargine: a retrospective database analysis.

OBJECTIVE: To examine resource utilization and healthcare costs associated with the use of exenatide versus glargine in type 2 diabetes (T2D) patients.
METHODS: A retrospective analysis comprised of patients with T2D initiating exenatide (n = 7,255) or glargine (n = 2,819) between 04/01/2005 and 06/30/2007. Propensity score matching was used (2,506 matched pairs) to control for baseline demographic, clinical, resource use, and cost variables to balance treatment groups. Mean medical costs and other cost components were estimated using nonparametric bootstrapping.
RESULTS: Exenatide-treated patients had 19% lower likelihood of all-cause hospitalizations (odds ratio [OR]: 0.81, p = 0.009) compared to glargine-treated patients. Exenatide-treated patients had significantly lower total medical costs of $2,597 (p = 0.008). Exenatide-treated patients had significantly lower inpatient costs of $1,968 (p = 0.004) and outpatient costs of $1,324 (p = 0.011), but higher prescription costs of $706 (p < 0.001). Exenatide-treated patients further incurred lower hospitalization costs of $1,910 (p = 0.005) and physician office visit costs of $608 (p = 0.008). KEY LIMITATIONS: Lack of availability of clinical measures including duration of diabetes, severity of T2D and lack of control for unmeasured confounding.
CONCLUSIONS: Patients initiating exenatide treatment had significantly lower healthcare resource utilization and total medical costs. Cost offsets were observed in inpatient and outpatient costs despite higher prescription costs.