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. 2024 Nov;22(6):861-869.
doi: 10.1007/s40258-024-00914-z. Epub 2024 Sep 16.

The Impact of Unrelated Future Medical Costs on Economic Evaluation Outcomes for Different Models of Diabetes

Ting Zhao  1 , Michelle Tew  2 , Talitha Feenstra  3   4 , Pieter van Baal  5 , Michael Willis  6 , William J Valentine  7 , Philip M Clarke  8   9 , Barnaby Hunt  7 , James Altunkaya  8 , An Tran-Duy  2   9 , Richard F Pollock  10 , Samuel J P Malkin  7 , Andreas Nilsson  6 , Phil McEwan  11 , Volker Foos  11 , Jose Leal  8 , Elbert S Huang  12 , Neda Laiteerapong  13 , Mark Lamotte  14 , Harry Smolen  15 , Jianchao Quan  16   17 , Luís Martins  14 , Mafalda Ramos  14 , Andrew J Palmer  18
Affiliations

The Impact of Unrelated Future Medical Costs on Economic Evaluation Outcomes for Different Models of Diabetes

Ting Zhao et al. Appl Health Econ Health Policy. 2024 Nov.

Abstract

Objective: This study leveraged data from 11 independent international diabetes models to evaluate the impact of unrelated future medical costs on the outcomes of health economic evaluations in diabetes mellitus.

Methods: Eleven models simulated the progression of diabetes and occurrence of its complications in hypothetical cohorts of individuals with type 1 (T1D) or type 2 (T2D) diabetes over the remaining lifetime of the patients to evaluate the cost effectiveness of three hypothetical glucose improvement interventions versus a hypothetical control intervention. All models used the same set of costs associated with diabetes complications and interventions, using a United Kingdom healthcare system perspective. Standard utility/disutility values associated with diabetes-related complications were used. Unrelated future medical costs were assumed equal for all interventions and control arms. The statistical significance of changes on the total lifetime costs, incremental costs and incremental cost-effectiveness ratios (ICERs) before and after adding the unrelated future medical costs were analysed using t-test and summarized in incremental cost-effectiveness diagrams by type of diabetes.

Results: The inclusion of unrelated costs increased mean total lifetime costs substantially. However, there were no significant differences between the mean incremental costs and ICERs before and after adding unrelated future medical costs. Unrelated future medical cost inclusion did not alter the original conclusions of the diabetes modelling evaluations.

Conclusions: For diabetes, with many costly noncommunicable diseases already explicitly modelled as complications, and with many interventions having predominantly an effect on the improvement of quality of life, unrelated future medical costs have a small impact on the outcomes of health economic evaluations.

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Conflict of interest statement

The authors declare no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Figures

Fig. 1
Fig. 1
Incremental cost-effectiveness diagram for type 1 diabetes before and after adding unrelated future medical costs. The ICERs for type 1 diabetes interventions before and after adding the unrelated future medical costs were nearly overlapping in the plane, which means there were only minor changes to ICERs after adding the unrelated future medical costs. As shown in the diagram, adding the unrelated future medical costs did not change any conclusions of the model outcome under the £20,000 per QALY gained threshold. Costs were presented in UK currency (£GBP 2017–2018). ICER incremental cost-effectiveness ratio, QALY quality-adjusted life-year
Fig. 2
Fig. 2
Incremental cost-effectiveness diagram for type 2 diabetes before and after adding unrelated future medical costs. The ICERs for type 2 diabetes interventions before and after adding the unrelated future medical costs were nearly overlapping in the plane, which means there were only minor changes to ICERs after adding the unrelated future medical costs. As shown in the diagram, adding the unrelated future medical costs did not change any conclusions of the model outcome under the £20,000 per QALY gained threshold. Costs were presented in UK currency (£GBP 2017-2018). ICER incremental cost-effectiveness ratio, QALY quality-adjusted life-year
See this image and copyright information in PMC

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