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. 2008 Aug;31(8):1510-5.
doi: 10.2337/dc07-2452. Epub 2008 Apr 28.

Cost-effectiveness of intensified versus conventional multifactorial intervention in type 2 diabetes: results and projections from the Steno-2 study

Peter Gaede  1 , William J Valentine, Andrew J Palmer, Daniel M D Tucker, Morten Lammert, Hans-Henrik Parving, Oluf Pedersen
Affiliations

Cost-effectiveness of intensified versus conventional multifactorial intervention in type 2 diabetes: results and projections from the Steno-2 study

Peter Gaede et al. Diabetes Care. 2008 Aug.

Abstract

Objective: To assess the cost-effectiveness of intensive versus conventional therapy for 8 years as applied in the Steno-2 study in patients with type 2 diabetes and microalbuminuria.

Research design and methods: A Markov model was developed to incorporate event and risk data from Steno-2 and account Danish-specific costs to project life expectancy, quality-adjusted life expectancy (QALE), and lifetime direct medical costs expressed in year 2005 Euros. Clinical and cost outcomes were projected over patient lifetimes and discounted at 3% annually. Sensitivity analyses were performed.

Results: Intensive treatment was associated with increased life expectancy, QALE, and lifetime costs compared with conventional treatment. Mean +/- SD undiscounted life expectancy was 18.1 +/- 7.9 years with intensive treatment and 16.2 +/- 7.3 years with conventional treatment (difference 1.9 years). Discounted life expectancy was 13.4 +/- 4.8 years with intensive treatment and 12.4 +/- 4.5 years with conventional treatment. Lifetime costs (discounted) for intensive and conventional treatment were euro45,521 +/- 19,697 and euro41,319 +/- 27,500, respectively (difference euro4,202). Increased costs with intensive treatment were due to increased pharmacy and consultation costs. Discounted QALE was 1.66 quality-adjusted life-years (QALYs) higher for intensive (10.2 +/- 3.6 QALYs) versus conventional (8.6 +/- 2.7 QALYs) treatment, resulting in an incremental cost-effectiveness ratio of euro2,538 per QALY gained. This is considered a conservative estimate because accounting prescription of generic drugs and capturing indirect costs would further favor intensified therapy.

Conclusions: From a health care payer perspective in Denmark, intensive therapy was more cost-effective than conventional treatment. Assuming that patients in both arms were treated in a primary care setting, intensive therapy became dominant (cost- and lifesaving).

Trial registration: ClinicalTrials.gov NCT00320008.

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Figures

Figure 1
Figure 1
Acceptability curve from base case analysis.
See this image and copyright information in PMC

References

    1. Saydah SH, Eberhardt MS, Loria CM, Brancati FL: Age and the burden of death attributable to diabetes in the United States. Am J Epidemiol 156:714–719, 2002 - PubMed
    1. Jönsson B, CODE-2 Advisory Board: Revealing the cost of Type II diabetes in Europe. Diabetologia 45:S5–S12, 2002. - PubMed
    1. American Diabetes Association: National Diabetes Fact Sheet [article online], 2005. Available from http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2005.pdf. Accessed 19 February 2007
    1. American Diabetes association. Standards of medical care for patients with diabetes mellitus (Position Statement). Diabetes Care 26(Suppl. 1):S33–S50, 2003 - PubMed
    1. Gæde P, Vedel P, Larsen N, Jensen GV, Parving HH, Pedersen O: Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes. N Engl J Med 348:383–393, 2003 - PubMed

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