Trends in Health Care Resources Utilization, Cost and Medication Selection in the Treatment of Diabetes


      Diabetes is one of the most common chronic diseases in Canada. It affects about 6.8% of the Canadian population. Treating and managing the disease and its complications is associated with a significant economic burden. The objective of this study was to analyse trends in terms resource utilization, cost and treatment patterns in the management of diabetes.


      Patients covered by the Quebec provincial drug reimbursement program (RAMQ) who had a diagnosis of diabetes, in 2005 and were covered continuously by the public drug program for the period from January 2006 to December 2010 were selected. Health care resources in terms of diabetes medications and physician visits, hospitalization, intensive care unit stay, hospital outpatient clinic visits, and emergency room visits associated with a diagnosis of diabetes were estimated over a 5-year period, from January 2006 to December 2010. Trends in the proportion of diabetes medications used each year over the 5-year study period were also estimated.


      A total of 46,194 diabetic patients were included in the study. The mean age of the study population was 65.4 years (SD=12.3) and proportion of male/female was 47% and 53% respectively. Over the study period, annual cost of diabetes medications varied from $320 (SD=464) in 2006 to $372 (SD=546) in 2010 (+16%) while total cost of treatment associated with diabetes varied from $627 (SD=1456) to $715 (SD=1632) (+14%) during that period. Metformine remains the most widely used medication throughout the study period with 64.3% of users in 2006 and 65.6% in 2010. Proportion of insulin users increased from 15.2% to 22.7% while gliclazide users increased from 4.4% to 11.2% during the study period.


      Over the five-year study period cost of diabetes treatment has increased at a rate similar to inflation, while trends of increased adoption of insulin and newer medications is observed.