Direct Medical Costs and Medication Use Trends in Patients Having Type 2 Diabetes with Chronic Kidney Disease in Beijing, China in 2016–2018

Abstract

Abstract Background Types of medications used and costs of drugs for patients having type 2 diabetes mellitus (T2DM) with chronic kidney disease (CKD) have not been evaluated in outpatients in Beijing, China. Objectives In this study, we aimed to assess the medical costs and use of anti-diabetic therapy in patients having T2DM with CKD in Beijing. Methods This observational, retrospective study included diabetic patients with outpatient records in the Beijing Medical Insurance database from 2016 to 2018 and analyzed the enrolled patients’ oral hypoglycemic drug use, insulin use, non-hypoglycemic drug use, comorbidities, T2DM-related complications, treatment strategies, and annual medical costs. Results This study recruited 2,853,036 patients with T2DM from the Beijing Medical Insurance database. Notably, 6.87–8.18% of diabetic patients were diagnosed as having CKD. Compared with diabetic patients without CKD, those with CKD showed significantly more diabetic complications (3.32 ± 1.6 vs. 2.09 ± 1.5), more types of medications used (4.8 ± 2.63 vs. 3.75 ± 2.33), and a higher total annual drug cost ($2,017 ± $1,627 vs. $1,350 ± $1260). CKD patients used significantly more types of medications and had significantly lower drug costs in 2018 (4.8 ± 2.62 and $2,017 ± $1,627 respectively) than in 2016 (4.78 ± 2.61 and $2,323 ± $1,885, respectively). Conclusion As routine CKD screening is currently not protocolized in Beijing’s outpatient process, CKD prevalence in T2DM patients with medical insurance is erroneously projected to be much lower in Beijing than in other areas of China. Early screening, diagnosis, and treatment of T2DM patients may delay the progress of CKD and reduce the future economic burden on the society.