Triglyceride Treatment: Cost Savings in Diabetes

FEBRUARY 02, 2017
Leah Mangini, 2017 PharmD Candidate, the University of Connecticut School of Pharmacy

According to the American Diabetes Association, diabetes cost individuals $13,700 per year on average. In 2012, diabetes care cost the United States a collective $245 billion. Dyslipidemia in diabetes most commonly manifests as high triglycerides and low high density lipoprotein, and is associated with higher costs of care. 
Researchers at Kaiser Permanente suggest that triglyceride-lowering therapy in patients with type 2 diabetes can decrease medical costs in a new study published in the American Journal of Cardiology
The research team conducted an observational study enrolling more than 184,000 patients with diabetes comparing triglyceride (TG) levels and medical costs before and after cholesterol and triglyceride-lowering therapy. They evaluated inpatient, outpatient, and medication costs before the first TG measurement and up to 1 year after the second.
Treatments varied between TG-specific monotherapy, statin monotherapy, statin and TG-specific combination therapy, and no therapy.
All lipid-lowering treatments produced economic benefit. Patients who received statin and TG-specific combination therapy saved more on average than those on either statin or TG-specific monotherapy. Savings associated with TG-specific monotherapy were marginally better than those associated with statin-monotherapy.
Overall, combination therapy that reduced TG levels by 30% or more produced the largest economic benefit. Statin monotherapy that reduced TG levels by the same amount was also associated with significant savings, but to a lesser degree. 
Interestingly, statistically significant cost savings were observed even when TG levels increased or stayed the same for patients on combination therapy.
The authors are unable to conclude from this study if cost savings are due to the changes in TG levels or the treatments received. They speculate that the reduced risk of cardiovascular disease associated with statin/TG-combination may contribute to cost savings, but they noted they cannot make this conclusion based on the data collected.

Nichols GA, Reynolds K, Olufade T, et al. Effect of combination cholesterol-lowering therapy and triglyceride-lowering therapy on medical costs in patients with type 2 diabetes mellitus. Am J Cardiol. 2017;119:410-415.