Health care costs and glycaemic control in type 2 diabetesin Swedish primary care

• Aims: The aim of this study was to explore the annual health care cost for patients with type 2diabetes and its association with glycaemic control in primary care. Methods: All patients with diabetes at 18 primary health care centres (PHCC) in Swedenwere surveyed in this cross sectional observational study. From a total population of 208 490,we identified 6495 patients with type 2 diabetes and information were retrieved from medicalrecords on resource utilisation, clinical data, treatment category and use of self monitoring ofblood glucose (SMBG). Data on costs for pharmaceuticals and test strips for SMBG wereimported from the general ledger. Results: The mean annual health care cost per patient with type 2 diabetes, was 586 Euro (SD435). Factors associated with high costs at individual level were; type of treatment (r=0.67),number of GP visits (r=0.61), use of SMBG (r=0.46), number of visits to nurse (r=0.34), andlevel of HbA1c (r=0.33). No association was found between costs per health care centre andmean HbA1c per PHCC (r=0.17). Use of SMBG was associated with high total cost evenwhen adjusted for duration of diabetes and treatment type (p<0.01). Conclusions: Health care costs for type 2 diabetes varied substantially in primary care,primarily explained by differences in costs for SMBG and insulin.

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