OBJECTIVES: Kuwait has high prevalence of type 1 and type 2 diabetes (18%), with great impact on healthcare services. The aim of this study is to explore the utilization patterns and costs of diabetes treatment and its complications in Kuwait.

METHODS: This study was a cross-sectional study. Patients were recruited from the six governorates of Kuwait from both primary and secondary care. Patients with diabetes aged 18 to 80 years old were included. Drug utilization data was collected for the year 2018. A generalized linear model with log transformation and normal distribution was performed to explore whether patients with complications and comorbidities will have higher drug costs after adjustments for confounders (gender, age group, facility type).

RESULTS: The study included 1182 patients from across Kuwait. The mean age was 56.3 (+/- 13.1) years. Most patients were females (65.3%) and most had type-2 diabetes (89.5%). The most common comorbidity was dyslipidemia (64.0%). Neuropathy was the most prevalent complication (19.7%). Majority of patients (81.0%) were on oral anti-diabetics, and 45.7% were on insulin’s, while 27.0% of patients were on oral anti-diabetics plus insulin. The most frequently used oral drug was metformin (70.5%), and most frequently used insulin was insulin glargine (33.7%). Patients were on chronic medications other than anti-diabetics, the most frequently used were lipid-lowering drugs (61.3%). The cost of drugs was 23.6% higher for patients with at least one comorbidity compared to none ([95% CI]= 2.8% - 48.5%, p-value=0.0245) and 29.1% higher for patients with at least one complication compared to none ([95% CI]= 13.8% - 46.6%, p-value<0.001). In year 2018, diabetes treatment and its complications costed the country 18% of its total drug budget.

CONCLUSIONS: Diabetes drug therapy has a high burden on the healthcare system. Patients with comorbidites and complications have higher drug costs.