Antidiabetic Drugs and In-patient Admissions Attributable to Diabetes in Portugal

Detalhes bibliográficos
Autor(a) principal: Gouveia, Miguel
Data de Publicação: 2012
Outros Autores: Laires, Pedro, Borges, Margarida, Augusto, Margarida, Martins, Ana Paula
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/294
Resumo: Introduction: The growth of oral antidiabetic drugs spending has led to concerns questioning the health gains and benefits for the health system generated by these drugs. This study contributes to answering these questions. Material and Methods: Initially we present estimates of the three variables central to the analysis: 1) the prevalence of treated diabetes per year and health region, based on the consumption of oral antidiabetic drugs, 2) the number of hospitalization episodes and their costs attributable to diabetes, based on the relative risks and 3) a quantitative characterization of the consumption of oral antidiabetics by calculating average vintages by year and region. Through the use of observations for 10 years and five regions, a total of 50 observations, it was possible to estimate an econometric model explaining statistically both hospitalizations and hospital costs attributable to diabetes by regional characteristics, treated prevalence and the average vintage of oral antidiabetic drugs. Results: The results of the multiple regression models show that hospital costs are proportional to the treated prevalence, all else constant, but that the more recent the oral antidiabetic drugs used, the lower are hospital costs. The effects on the number of hospitalizations are similar. Discussion and Conclusions: For an average observation in the sample, if the average vintage of oral hypoglycemic agents had one additional year, then hospital costs would have a 5.3% reduction (about 11 million € in 2009) and the number of admissions would suffer a 3.8% reduction (about 3965 less episodes in 2009). A counterfactual exercise allows us to estimate that for 2009 the introduction of the class of DPP IV inhibitors reduced the number of hospitalizations attributable to diabetes by 8480 and saved € 23.3 million in hospital costs.
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spelling Antidiabetic Drugs and In-patient Admissions Attributable to Diabetes in PortugalAntidiabéticos Orais e Internamentos Atribuíveis à Diabetes em PortugalIntroduction: The growth of oral antidiabetic drugs spending has led to concerns questioning the health gains and benefits for the health system generated by these drugs. This study contributes to answering these questions. Material and Methods: Initially we present estimates of the three variables central to the analysis: 1) the prevalence of treated diabetes per year and health region, based on the consumption of oral antidiabetic drugs, 2) the number of hospitalization episodes and their costs attributable to diabetes, based on the relative risks and 3) a quantitative characterization of the consumption of oral antidiabetics by calculating average vintages by year and region. Through the use of observations for 10 years and five regions, a total of 50 observations, it was possible to estimate an econometric model explaining statistically both hospitalizations and hospital costs attributable to diabetes by regional characteristics, treated prevalence and the average vintage of oral antidiabetic drugs. Results: The results of the multiple regression models show that hospital costs are proportional to the treated prevalence, all else constant, but that the more recent the oral antidiabetic drugs used, the lower are hospital costs. The effects on the number of hospitalizations are similar. Discussion and Conclusions: For an average observation in the sample, if the average vintage of oral hypoglycemic agents had one additional year, then hospital costs would have a 5.3% reduction (about 11 million € in 2009) and the number of admissions would suffer a 3.8% reduction (about 3965 less episodes in 2009). A counterfactual exercise allows us to estimate that for 2009 the introduction of the class of DPP IV inhibitors reduced the number of hospitalizations attributable to diabetes by 8480 and saved € 23.3 million in hospital costs.Introdução: O crescimento da despesa com antidiabéticos orais tem levado a preocupações questionando os ganhos de saúde e vantagens para o sistema de saúde gerados por esses medicamentos. Este estudo contribui para responder a estas questões. Material e Métodos: Numa primeira fase apresentam-se estimativas das três variáveis centrais a utilizar na análise: 1) a prevalência tratada da diabetes por ano e por região de saúde baseadas nos consumos de antidiabéticos orais, 2) o número de episódios de internamento hospitalar atribuíveis à diabetes com base nos riscos relativos das várias patologias e os seus custos e 3) uma caracterização quantitativa dos antidiabéticos orais consumidos através do cálculo da sua vintage média. Através do uso de observações para 10 anos e cinco regiões, perfazendo um total de 50 observações, foi possível estimar um modelo econométrico explicando estatisticamente os internamentos e os custos hospitalares atribuíveis à diabetes por características regionais, pela prevalência tratada e pela vintage média dos antidiabéticos orais. Resultados: Os resultados dos modelos de regressão múltipla mostram que as despesas hospitalares são proporcionais à prevalência tratada, tudo o mais constante mas que quanto mais recente for a vintage dos antidiabéticos orais usados menores são os custos hospitalares. Os efeitos para o número de internamentos são similares. Discussão e Conclusões: Para uma observação média na amostra, se a vintage média dos antidiabéticos orais fosse um ano superior então os custos hospitalares seriam 5,3% inferiores (cerca de € 11 milhões em 2009) e o número de internamentos seria 3,8% menor (cerca de menos 3965 episódios em 2009). Um exercício contra factual permite estimar que para o ano de 2009 a introdução da classe dos inibidores de DPP IV permitiu reduzir o número de internamentos atribuíveis à diabetes em 8480 e com isso poupar €23,3 milhões em custos hospitalares.Ordem dos Médicos2012-11-12info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/x-pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/294oai:ojs.www.actamedicaportuguesa.com:article/294Acta Médica Portuguesa; Vol. 25 No. 5 (2012): September-October; 323-331Acta Médica Portuguesa; Vol. 25 N.º 5 (2012): Setembro-Outubro; 323-3311646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/294https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/294/87Gouveia, MiguelLaires, PedroBorges, MargaridaAugusto, MargaridaMartins, Ana Paulainfo:eu-repo/semantics/openAccess2022-12-20T10:55:59Zoai:ojs.www.actamedicaportuguesa.com:article/294Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:16:27.400910Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Antidiabetic Drugs and In-patient Admissions Attributable to Diabetes in Portugal
Antidiabéticos Orais e Internamentos Atribuíveis à Diabetes em Portugal
title Antidiabetic Drugs and In-patient Admissions Attributable to Diabetes in Portugal
spellingShingle Antidiabetic Drugs and In-patient Admissions Attributable to Diabetes in Portugal
Gouveia, Miguel
title_short Antidiabetic Drugs and In-patient Admissions Attributable to Diabetes in Portugal
title_full Antidiabetic Drugs and In-patient Admissions Attributable to Diabetes in Portugal
title_fullStr Antidiabetic Drugs and In-patient Admissions Attributable to Diabetes in Portugal
title_full_unstemmed Antidiabetic Drugs and In-patient Admissions Attributable to Diabetes in Portugal
title_sort Antidiabetic Drugs and In-patient Admissions Attributable to Diabetes in Portugal
author Gouveia, Miguel
author_facet Gouveia, Miguel
Laires, Pedro
Borges, Margarida
Augusto, Margarida
Martins, Ana Paula
author_role author
author2 Laires, Pedro
Borges, Margarida
Augusto, Margarida
Martins, Ana Paula
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Gouveia, Miguel
Laires, Pedro
Borges, Margarida
Augusto, Margarida
Martins, Ana Paula
description Introduction: The growth of oral antidiabetic drugs spending has led to concerns questioning the health gains and benefits for the health system generated by these drugs. This study contributes to answering these questions. Material and Methods: Initially we present estimates of the three variables central to the analysis: 1) the prevalence of treated diabetes per year and health region, based on the consumption of oral antidiabetic drugs, 2) the number of hospitalization episodes and their costs attributable to diabetes, based on the relative risks and 3) a quantitative characterization of the consumption of oral antidiabetics by calculating average vintages by year and region. Through the use of observations for 10 years and five regions, a total of 50 observations, it was possible to estimate an econometric model explaining statistically both hospitalizations and hospital costs attributable to diabetes by regional characteristics, treated prevalence and the average vintage of oral antidiabetic drugs. Results: The results of the multiple regression models show that hospital costs are proportional to the treated prevalence, all else constant, but that the more recent the oral antidiabetic drugs used, the lower are hospital costs. The effects on the number of hospitalizations are similar. Discussion and Conclusions: For an average observation in the sample, if the average vintage of oral hypoglycemic agents had one additional year, then hospital costs would have a 5.3% reduction (about 11 million € in 2009) and the number of admissions would suffer a 3.8% reduction (about 3965 less episodes in 2009). A counterfactual exercise allows us to estimate that for 2009 the introduction of the class of DPP IV inhibitors reduced the number of hospitalizations attributable to diabetes by 8480 and saved € 23.3 million in hospital costs.
publishDate 2012
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dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 25 No. 5 (2012): September-October; 323-331
Acta Médica Portuguesa; Vol. 25 N.º 5 (2012): Setembro-Outubro; 323-331
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