Type 2 diabetes mellitus (T2D) is a growing healthcare burden primarily due to long-term complications. Strict glycemic control helps in preventing complications, and early introduction of insulin may be more cost-effective than maintaining patients on multiple oral agents. This is an expert opinion review based on English peer-reviewed articles (2000–2012) to discuss the health economic consequences of T2D treatment intensification. T2D costs are driven by inpatient care for treatment of diabetes complications (40%–60% of total cost), with drug therapy for glycemic control representing 18% of the total cost. Insulin therapy provides the most improved glycemic control and reduction of complications, although hypoglycemia and weight gain may occur. Early treatment intensification with insulin analogs in patients with poor glycemic control appears to be cost-effective and improves clinical outcomes. Key Messages • Type 2 diabetes mellitus is a growing burden on healthcare services. • Despite the high cost of drug therapy versus diet and lifestyle interventions, treatment intensification with insulin analog therapy is a cost-effective strategy for improving clinical outcomes in patients with poor glycemic control.
Evaluating associations between the benefits and risks of drug therapy in type 2 diabetes: a joint modeling approach
