International Society for Pediatric and Adolescent Diabetes
ISPAD 2014 | 40th Anniversary |
225
Poster Tour 17: Regimen-Based Innovations II
P135
Insulin pump therapy in childhood diabetes - cost implications
F. Karachaliou
1
, K. Athanasakis
2
, C. Tsendidis
3
, M. Kitra
3
, G. Simatos
1
, S. Michalakos
1
, K.
Karavanaki
3
1
P & A Kyriakou Children's Hospital, Endocrinology, Athens, Greece,
2
National School of Public
Health, Department of Health Economics, Athens, Greece,
3
P & A Kyriakou Children's Hospital,
Diabetic Clinic, 2nd Department of Pediatrics, Athens, Greece
Objectives:
To examine the predictors of elevated direct costs of pediatric type 1 diabetes (T1DM) in
the National Health System in Greece and the cost of implications of insulin pump therapy.
Methods:
All T1DM patients, followed in the University Diabetic Clinic of one of the two major
Children's hospitals in Athens, from 1
st
January 2011 to 31
st
December 2012 were included. Data on
age, gender,insulin dosage ,type of insulin regimen, outpatient visits and hospital diabetes-related
admissions, laboratory tests and supplies costs were collected. Metabolic control was estimated as the
mean of all HbA1c measurements over the 2-years study period.
Results:
Total diabetes-related direct costs per person-
year were estimated at €2,712 (95% CI: 2,468
-
2,956).Diabetes healthcare provider visits including laboratory tests, accounted for only 7.6% of total
costs. Costs for hospitalizations were only 1.7%. Medication costs were 17% and were the highest for
multi-injection therapy. Supply costs accounted for 73.7% and were the highest for insulin pump
therapy (p=0.0001). Multivariate linear regression analysis showed that total costs were significantly
higher for a) pump therapy (p< 0.0001), b) older age (p< 0.001) and c) daily insulin dose (p< 0.001).
Patients on pump therapy ha
d significantly higher cost €5,538 (95%CI:4,480
-6,597) compared to
patients on multi-
injection €2,447 (95%CI:2,320
-
2,574) and conventional regimen €1,978.5
(95%CI:1,682-2,275) (p=0.0001). However, patients on pump therapy had better glycaemic control
compared to the rest of the patients (HbA1c: 7.2±1.0 vs 8.3±1.5%, p=0.039).
Conclusion:
The main factor that predicted direct cost of diabetes care was the use of pump. Supply
costs accounted for the majority of annual direct costs. However, the use of pump was associated with
better glycaemic control, which has to be co-estimated, since long-term microvascular complications
constitute the major component of the total long-term diabetes care cost.
