40-PUB: Medical Costs for Adults with Type 2 Diabetes with and without Osteoarthritis of the Knee or Obstructive Sleep Apnea

Introduction and Objective: Research has shown an association between obstructive sleep apnea (OSA) and osteoarthritis, and both OSA and knee osteoarthritis (KOA) are found at higher rates in people with type 2 diabetes (T2D) compared to those without T2D. This study examines medical costs for adults with T2D with and without comorbid OSA and/or KOA. Methods: The study uses Optum Market Clarity U.S. data for 2021 - 2023. Adults with T2D were grouped based upon the presence of OSA and/or KOA. Annual costs for 2022 and 203 were examined using multivariable analyses. Results: For the 108,498 people with T2D in the study, the mean age was 66.3 years (SD=11.9 years) and 50.6% were female. Comorbid OSA was present in 18,977 (17.5%) people, 9,756 (9.0%) had comorbid KOA, 3,794 (3.5%) had both OSA and KOA, and 75,971 (70.0%) had neither. Estimated annual all-cause total medical costs were highest for people with OSA and KOA ($69,726 [SD=$45,795]). Costs for people with KOA or OSA only were $45,248 (SD= $29,679) and $53,829 (SD=$35,452), respectively (P<0.0001) for difference in costs for the 4 groups). The component costs of outpatient, drug and acute care costs followed a similar pattern (see Figure). Conclusion: Among adults with T2D the presence of comorbid KOA and/or OSA results in significant increases in all-cause total medical costs, with the highest costs observed in people with both conditions. Disclosure K. Terrell: Employee; Current; Eli Lilly and Company. M.J. Lage: Consultant; Current; Eli Lilly and Company. J. Paik: Employee; Current; Lilly. K.S. Boye: Employee; Current; Lilly. Stock/Shareholder; Current; Lilly.