Assessing the economic value of maintained improvements in Type 1 diabetes management, in terms of HbA1c , weight and hypoglycaemic event incidence.
Diabet Med
; 35(5): 557-566, 2018 05.
Article
en En
| MEDLINE
| ID: mdl-29377320
ABSTRACT
AIMS:
Insulin therapy is indicated for people with Type 1 diabetes mellitus; however, treatment-related weight gain and hypoglycaemia represent barriers to optimal glycaemic management. This study assessed the health economic value of maintained reductions in HbA1c , BMI and hypoglycaemia incidence among the UK Type 1 diabetes population.METHODS:
The Cardiff Type 1 Diabetes Model was used to estimate lifetime costs, life-years and quality-adjusted life-years (QALYs) for individuals with Type 1 diabetes at different baseline HbA1c , BMI and hypoglycaemic event rates. Results were discounted at 3.5%, and the net monetary benefit associated with improving Type 1 diabetes management was derived at £20 000/QALY gained. Per-person outputs were inflated to national levels using UK Type 1 diabetes prevalence estimates.RESULTS:
Modelled subjects with an HbA1c of 86 mmol/mol (10.0%) were associated with discounted lifetime per-person costs of £23 795; £12 649 of which may be avoided by maintaining an HbA1c of 42 mmol/mol (6.0%). Combined with estimated QALY gains of 2.80, an HbA1c of 42 mmol/mol (6.0%) vs. 86 mmol/mol (10.0%) was associated with a £68 621 per-person net monetary benefit. Over 1 year, unit reductions in BMI produced £120 per-person net monetary benefit, and up to £197 for the avoidance of one non-severe hypoglyceamic event.CONCLUSIONS:
Maintained reductions in HbA1c significantly alleviate the burden associated with Type 1 diabetes in the UK. Given the influence of weight and hypoglycaemia on health economic outcomes, they must also be key considerations when assessing the value of Type 1 diabetes technologies in clinical practice.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Aumento de Peso
/
Costos de la Atención en Salud
/
Años de Vida Ajustados por Calidad de Vida
/
Diabetes Mellitus Tipo 1
/
Hipoglucemia
/
Hipoglucemiantes
/
Insulina
Tipo de estudio:
Health_economic_evaluation
/
Incidence_studies
/
Risk_factors_studies
Límite:
Adult
/
Female
/
Humans
/
Male
País/Región como asunto:
Europa
Idioma:
En
Revista:
Diabet Med
Asunto de la revista:
ENDOCRINOLOGIA
Año:
2018
Tipo del documento:
Article