3.8 Article

Delineating the Type 2 Diabetes Population in the Netherlands Using an All-Payer Claims Database: Specialist Care, Medication Utilization and Expenditures 2016-2018

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PHARMACOECONOMICS-OPEN
卷 6, 期 2, 页码 219-229

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SPRINGER INT PUBL AG
DOI: 10.1007/s41669-021-00308-0

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  1. AstraZeneca BV, The Netherlands

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Healthcare utilization and expenditures related to medical specialist care and medication of the entire type 2 diabetes population in the Netherlands are diverse, with a skewed distribution of spending. These heterogeneous healthcare use patterns may be caused by comorbidities, and a small fraction of the population is responsible for a large share of the expenditures. A shift towards more patient-centered care could lead to health improvements and a reduction in overall costs, subsequently promoting the sustainability of healthcare systems.
Objectives The aim of this study was to describe the healthcare utilization and expenditures related to medical specialist care and medication of the entire type 2 diabetes population in the Netherlands in detail. Methods For this retrospective, observational study, we used an all-payer claims database. Comprehensive data on specialist care and medication utilization and expenditures of the type 2 diabetes population (n = 900,522 in 2018) were obtained and analyzed descriptively. Data were analyzed across medical specialties and for various types of diabetes medication (or glucose-lowering drugs [GLDs]) and other medication. Results Specialist care utilization was diverse: different medical specialties were visited by a considerable fraction of the type 2 diabetes population. Total expenditures on specialist care were euro2498 million in 2018 (i.e., 10.6% of the national specialist care expenditures). In total, 97.8% of patients used other medication (not GLDs) and 81.8% used GLDs; 25.6% of medication expenditures were for GLDs. For both specialist care and medication, mean expenditures per treated patient were higher than median expenditures, indicating a skewed distribution of spending. Conclusion Use of and expenditures on specialist care and medication of the type 2 diabetes population is diverse. These heterogeneous healthcare use patterns are likely caused by the presence of comorbidities. Additionally, we found that a small fraction of the population is responsible for a large share of the expenditures. A shift towards more patient-centered care could lead to health improvements and a reduction in overall costs, subsequently promoting the sustainability of healthcare systems.

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