Introduction: The estimated economic costs of diabetes was $327B in 2017 and is forecasted to increase to $494B by 2030. This study compares total health care costs for adults with T2D with glycemic control (HbA1c < 7%) compared to poor glycemic control (HbA1c ≥ 7%).

Methods: The Optum’s de-identified Clinformatics® Data Mart database from 1/1/2015 - 6/30/2021 was used to identify a cohort of adults with T2D with an index date of first recorded HbA1c test between 1/1/2016 - 7/1/2020 and continuous insurance from 1 year prior through 1 year post index date. Patients with glycemic control were propensity score matched to patients with poor glycemic control. Generalized linear models and two-part models examined all-cause total medical costs in 2021 dollars as well as outpatient, drug, and acute care costs over the 1- year post-period.

Results: Results from the matched cohort (N=59,830) indicate that glycemic control was associated with significantly lower annual total, acute, and drug costs but significantly higher outpatient costs (see Figure 1; all P<0.05). Sensitivity analyses using ≤ 6.5% and < 8% HbA1c thresholds showed that being below threshold was associated with significantly lower total medical costs.

Conclusion: Glycemic control was associated with significantly lower annual all-cause total medical costs. Results suggest economic benefits associated with having HbA1c at or below target.


J.P.Bae: None. V.Thieu: None. M.J.Lage: Consultant; Eli Lilly and Company. K.Boye: Employee; Eli Lilly and Company.

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