1271-P: Health Care Utilization and Cost with Empagliflozin vs. GLP-1RA in Patients with Type 2 Diabetes

Introduction & Objective: Despite the established cardiovascular benefits of empagliflozin (EMPA) and glucagon-like peptide-1 receptor agonists (GLP-1RA), questions remain on their impact on healthcare resource utilization (HCRU) and costs. Methods: Using US Medicare fee-for-service (FFS) and Optum commercial claims (2014-19), we identified 1:1 propensity score (PS)-matched patients aged >18 years with type 2 diabetes (T2D) initiating EMPA or GLP-1RA. We estimated rate ratios (RR) and rate differences (RD) for HCRU per 1,000 person-years, and costs per member per year (PMPY) differences, overall and in patients with baseline cardiovascular disease (CVD). Results: In 112,942 PS-matched FFS patients, EMPA was associated with similar no. of hospitalizations [RR 0.99 (0.93,1.04); RD -52 (-134, 36)], inpatient days [RR (95% CI) 0.97 (0.91, 1.02); RD -4 (-18, 10)], and no. of emergency room visits [RR 0.98 (0.94,1.01); RD -13 (-32, 6)], vs GLP-1RA. (Table). Estimates were similar in patients with CVD. Relative to GLP-1RA, EMPA was associated with lower total costs ($) [PMPY -1116 (-1359, -871)] and pharmacy costs [PMPY -800 (-934, -664)], with similar inpatient costs [PMPY 4 (-134,148)]. Findings were similar in patients with CVD. Findings from a commercial population were similar. Conclusion: For adults with T2D, initiating EMPA versus GLP-1RA resulted in similar HCRU with lower total and pharmacy costs.