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Association between the Diabetes Drug Cost and Cardiovascular Events and Death in Korea: A National Health Insurance Service Database Analysis

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Author(s)
Seung Min ChungJi-In LeeEugene HanHyun-Ae SeoEonju JeonHye Soon KimJi Sung Yoon
Keimyung Author(s)
Han, Eu Gene
Department
Dept. of Internal Medicine (내과학)
Journal Title
Endocrinol Metab (Seoul)
Issued Date
2022
Volume
37
Issue
5
Keyword
Cardiovascular diseasesCosts and cost analysisDiabetes mellitusMortality
Abstract
Backgruound:
This study aimed to investigate the long-term effects of diabetes drug costs on cardiovascular (CV) events and death.

Methods:
This retrospective observational study used data from 2009 to 2018 from the National Health Insurance in Korea. Among the patients with type 2 diabetes, those taking antidiabetic drugs and who did not have CV events until 2009 were included. Patients were divided into quartiles (Q1 [lowest]-4 [highest]) according to the 2009 diabetes drug cost. In addition, the 10-year incidences of CV events (non-fatal myocardial infarction, stroke, hospitalization for heart failure, and coronary revascularization) and CV death (death due to CV events) were analyzed.

Results:
A total of 441,914 participants were enrolled (median age, 60 years; men, 57%). CV events and death occurred in 28.1% and 8.36% of the patients, respectively. The 10-year incidences of CV events and deaths increased from Q1 to 4. After adjusting for sex, age, income, type of diabetes drugs, comorbidities, and smoking and drinking status, the risk of CV events significantly increased according to the sequential order of the cost quartiles. In contrast, the risk of CV death showed a U-shaped pattern, which was the lowest in Q3 (hazard ratio [HR], 0.953; 95% confidence interval [CI], 0.913 to 0.995) and the highest in Q4 (HR, 1.266; 95% CI, 1.213 to 1.321).

Conclusion:
Diabetes drug expenditure affects 10-year CV events and mortality. Therefore, affording an appropriate diabetes drug cost at a similar risk of CV is an independent protective factor against CV death.
Keimyung Author(s)(Kor)
한유진
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
2093-5978
Source
https://www.e-enm.org/journal/view.php?doi=10.3803/EnM.2022.1515
DOI
10.3803/EnM.2022.1515
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44528
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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