Introduction: Alcohol use disorder (AUD) is associated with adverse health outcomes in patients with diabetes mellitus (DM) and chronic kidney disease (CKD). This study examined healthcare resource use (HRU) and costs associated with comorbid AUD in patients with DM and CKD.
Methods: This retrospective cohort study identified adults with ≥1 inpatient or ≥2 outpatient claims for DM or CKD (MarketScan® and Medicare [1/1/2016-12/31/2020], Medicaid [1/1/2016-12/31/2019] databases), and ≥1 y of continuous healthcare enrollment before diagnosis (baseline period) and 3 mo after. Moderate-to-severe AUD was verified during baseline. HRU and costs were compared between propensity-score matched AUD and non-AUD patients in the DM and CKD cohorts, accounting for baseline demographics and other characteristics.
Results: 1,580,531 patients with DM and 1,155,142 patients with CKD were identified. Before matching, patients with AUD and DM (n=12,340) or CKD (n=14,472) were more likely to be younger, male, and have a higher comorbidity burden than patients without AUD. In matched cohorts, patients with DM and AUD had higher rates of inpatient (54%) and ED visits (27%), and longer inpatient stays (59%) vs non-AUD patients. Patients with CKD and AUD also had higher rates of inpatient (60%) and ED visits (35%), and longer inpatient stays (65%) vs non-AUD patients. Patients with AUD in both cohorts had slight increases in outpatient visits, fewer outpatient pharmacy claims, lower pharmacy costs, and higher total costs vs non-AUD patients.
Conclusion: Among patients with DM or CKD, comorbid AUD was associated with increased acute care utilization and total healthcare costs. Patients with comorbid AUD had lower outpatient pharmacy utilization which may increase the risk of suboptimal health outcomes in this population. These findings highlight the importance of effective AUD screening as part of a comprehensive care plan in patients with DM or CKD.
R. Grebla: Employee; Alkermes, Inc. Stock/Shareholder; Alkermes, Inc. L.P. Strand: Employee; Alkermes, Inc. Stock/Shareholder; Alkermes, Inc. S. Zhou: Consultant; Alkermes, Inc. X. Zhao: None. A. Keshishian: Consultant; Alkermes, Inc. M. McClain: Consultant; Alkermes, Inc. S. Springer: Research Support; National Institutes of Health, Veterans Administration. Other Relationship; Indivor Pharmaceuticals, Alkermes, Inc. Consultant; Alkermes, Inc.
This study was supported by Alkermes Inc.
