{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T02:10:30Z","timestamp":1762999830335,"version":"3.37.3"},"reference-count":40,"publisher":"American Diabetes Association","issue":"11","license":[{"start":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T00:00:00Z","timestamp":1719273600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["K08AG055670"],"award-info":[{"award-number":["K08AG055670"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Boehringer Ingelheim","award":["116283"],"award-info":[{"award-number":["116283"]}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,11,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>We compared health care resource utilization (HCRU) and costs for inpatient and outpatient services and dispensed medications in older adults with type 2 diabetes initiating empagliflozin versus dipeptidyl peptidase 4 inhibitors (DPP-4is).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>The study population included U.S. Medicare fee-for-service beneficiaries with diabetes (age \u226565 years) initiating empagliflozin or DPP-4is (August 2014 to September 2018). We estimated rate ratios (RRs) for HCRU outcomes using zero-inflated negative binomial regression and per-member per-year (PMPY) cost differences using generalized linear model with gamma distributions, overall and stratified by baseline cardiovascular disease (CVD), after adjusting for 143 baseline covariates using 1:1 propensity score matching.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>We identified 23,335 matched pairs (mean age 72 years, 51% with baseline CVD). HCRU rates were lower in empagliflozin versus DPP-4i initiators (number of inpatient days, RR 0.89 [95% CI 0.82, 0.97]; number of emergency department [ED] visits, 0.86 [0.82, 0.91]; number of hospitalizations, 0.86 [0.79, 0.93]; number of office visits, 0.96 [0.95, 0.98]). Inpatient cost (\u2212$713 PMPY [95% CI \u2212847, \u2212579), outpatient cost (\u2212$198 PMPY [\u2212272, \u2212124]), and total cost of care (\u2212$1,109 PMPY [\u22121,478, \u2212739]) were lower for empagliflozin versus DPP-4is, although diabetes medication cost was higher in empagliflozin initiators ($454 PMPY [95% CI 284, 567]). In the CVD subgroup, total cost was lower for empagliflozin initiators (\u2212$2,005 PMPY [\u22122,451, \u22121,337]), while the difference was attenuated in the non-CVD subgroup (\u2212$296 PMPY [\u2212740, 148]).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Among older adults with diabetes, empagliflozin was associated with a lower number of inpatient days, hospitalizations, ED visits, and office visits and with lower costs of care compared with DPP-4is, especially in those with history of CVD.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc24-0270","type":"journal-article","created":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T18:33:02Z","timestamp":1719340382000},"page":"1900-1907","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":3,"title":["Health Care Utilization and Costs Associated With Empagliflozin in Older Adults With Type 2 Diabetes"],"prefix":"10.2337","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4742-8306","authenticated-orcid":false,"given":"Phyo Than","family":"Htoo","sequence":"first","affiliation":[{"name":"1Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehdi","family":"NajafZadeh","sequence":"additional","affiliation":[{"name":"1Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen","family":"Tesfaye","sequence":"additional","affiliation":[{"name":"1Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian","family":"Schneeweiss","sequence":"additional","affiliation":[{"name":"1Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deborah J.","family":"Wexler","sequence":"additional","affiliation":[{"name":"2Massachusetts General Hospital Diabetes Center, Harvard Medical School, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert J.","family":"Glynn","sequence":"additional","affiliation":[{"name":"1Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niklas","family":"Schmedt","sequence":"additional","affiliation":[{"name":"3Global Epidemiology, Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anouk","family":"D\u00e9ruaz-Luyet","sequence":"additional","affiliation":[{"name":"3Global Epidemiology, Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisette","family":"Koeneman","sequence":"additional","affiliation":[{"name":"4Global Medical Affairs, Lilly Deutschland GmbH, Bad Homburg vor der H\u00f6he, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie M.","family":"Paik","sequence":"additional","affiliation":[{"name":"1Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisabetta","family":"Patorno","sequence":"additional","affiliation":[{"name":"1Division of Pharmacoepidemiology and 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