Diabetes Care, Vol 15, Issue 7 870-876, Copyright © 1992 by American Diabetes Association
Use of health maintenance organization data bases to study pharmacy resource usage in diabetes mellitus
HS Glauber and JB Brown
Center for Health Research, Kaiser Permanente Northwest Region, Portland, Oregon.
OBJECTIVE--To evaluate use of medications by patients with diabetes.
RESEARCH DESIGN AND METHODS--We analyzed the computerized pharmacy data
base of a large health maintenance organization to evaluate cost impact and
patterns of usage for all pharmacy products by a defined population of
diabetic patients. RESULTS--Diabetic patients received 31.2 dispenses/yr
compared with 11.5 for control patients. Total pharmacy costs were
threefold higher for diabetic patients ($621 vs. 207/yr) and accounted for
approximately 17% of their total health-care costs. Products specifically
for the care of diabetes averaged $175/yr or approximately 4.5% of their
total health-care costs: 57% received an oral hypoglycemic agent, 34%
received insulin, and 6% received both. Cardiovascular drugs accounted for
29% of total costs. There was increased use of most classes of medication
by patients with diabetes. CONCLUSIONS--Health maintenance organization
management data bases, particularly those storing pharmacy dispensing data,
provide useful information on the impact of chronic disease. People with
diabetes receive a greater number of most types of medication with a
greater overall cost than do nondiabetic people. Previous studies have
underestimated the contribution of pharmacy purchases to the costs of
caring for a diabetic population.