Endocrine Abstracts

Background: Mild hypoglycemia in elderly is associated with significant chronic consequences leading to physical and cognitive dysfunction and eventually frailty and disability. Mild hypoglycemia appears to be under-recognized in real-world clinical settings in the elderly and can lead to significant costs for patients.

Objective: To calculate cost-savings due to mild hypoglycemia reduction for SGLT-2 inhibitor versus SU initiation after metformin for elderly Ontarians with type 2 diabetes.

Methods: An economic model was calculated incorporating data from RCTs on SGLT2I for mild hypoglycemia. Data on prevalence of type 2 diabetes and SU utilization for elderly in Ontario were obtained from published data from Institute for Clinical Evaluative Sciences (ICES). Costs per event for mild hypoglycemia were obtained from published studies.

Results: With assumption of only one mild hypoglycemia during the first year of SU versus SGLT2 inhibitor initiation as add-on to metformin for the elderly Ontarian population with type 2 diabetes, the total cost from the patients’ perspective would lead to an annual cost-savings of CDN $2 066 224 due to less cost for mild hypoglycemia episodes treatment. Sensitivity analysis resulted in a minimum annual cost-savings of CDN $691 048 and a maximum annual cost-savings of CDN $8 402 373 for SGLT-2 inhibitor versus SU initiation after metformin due to mild hypoglycemia reduction for the Canadian population with type 2 diabetes.

Conclusion: This study illustrates that reduction in mild hypoglycemia episodes (which mostly are not reported in real-world clinical settings) due to SGLT2I utilization instead of SU in elderly Ontarian with type 2 diabetes can lead to a significant cost-savings from patients’ perspective.