The Cost Effectiveness of Fenofibrate Therapy for Treatment of Type II Diabetes Amongst Middle-Aged Adults: An Economic Analysis of the FIELD Study

2007 ◽  
Vol 16 ◽  
pp. S83
Author(s):  
S. Stewart ◽  
M.J. Carrington
Keyword(s):  
Cost Effectiveness ◽  
Economic Analysis ◽  
Field Study ◽  
Type Ii Diabetes ◽  
Type Ii ◽  
Middle Aged ◽  
The Cost ◽  
Middle Aged Adults

scholarly journals Valutazione economica dello studio CARDS: un aggiornamento

2011 ◽  
Vol 12 (2S) ◽  
pp. 35-40 ◽  
Author(s):  
Simona De Portu ◽  
Sabato Montella ◽  
Paolo Cortesi ◽  
Enrica Menditto ◽  
Lorenzo G. Mantovani
Keyword(s):  
Cost Effectiveness ◽  
Incremental Cost ◽  
Type Ii Diabetes ◽  
Cardiovascular Events ◽  
Price Reduction ◽  
Diabetic Patients ◽  
Type Ii ◽  
Management Of Complications ◽  
The Cost ◽  
Diabetes Patients

Introduction: in the last decades, prevalence and incidence of type II diabetes mellitus have been rapidly growing worldwide. Most recent projections estimate that the number of people affected by diabetes is destined to double in 2030, producing a significant increase of the healthcare expenditure for the management of complications. Prevention of cardiovascular events in diabetes population represents a priority for decision makers, who have to evaluate the cost-effectiveness of therapeutic interventions. Objective: to provide an updated cost-effectiveness evaluation of treating type II diabetes patients with atorvastatin versus placebo, in the light of the imminent price reduction of atorvastatin due to loss of exclusivity and of other therapeutic and hospital costs. Material and Methods: we derived clinical information from the CARDS study, a randomized, multicenter clinical trial evaluating efficacy of atorvastatin versus placebo in preventing the occurrence of cardiovascular events in a cohort of type II diabetes patients without previous history of coronary events. A cost-effectiveness analysis in the perspective of the National Healthcare System (SSN) has been performed, under the hypothesis of the imminent price reduction of atorvastatin, due to the loss of exclusivity. Results: after a median follow up of 3.9 years, the number of patients with at least a major cardiovascular event requiring hospitalization was lower in the atorvastatin arm (5.8%) compared to the placebo arm (9.0%; p=0.001). Based on a cohort of 1,000 patients, treatment with atorvastatin permitted to gain 29.28 life years. The incremental cost of adding atorvastatin to the standard therapy amounted to €305,682, and was partially balanced by a cost reduction due to fewer hospitalizations, compared to the placebo arm (€ 168,313). Total direct costs were of €602.186 in the atorvastatin group and of € 464,818 in the placebo group, resulting into an incremental cost-effectiveness ratio of € 4,692 for Life Year Gained (LYG). Conclusion: the present study is an update of a previous economic analysis of the CARDS trial. Under the assumed new cost scenario, the cost-effectiveness profile of treating diabetic patients with atorvastatin becomes highly favourable, and leads to a significant reduction of the cost for Life Year Gained compared to the previous findings.

Cost-effectiveness of Bariatric Surgery: Increasing the Economic Viability of the Most Effective Treatment for Type II Diabetes Mellitus

2015 ◽  
Vol 81 (8) ◽  
pp. 807-811 ◽  
Author(s):  
Jeremy A. Warren ◽  
Joseph A. Ewing ◽  
Allyson L. Hale ◽  
Dawn W. Blackhurst ◽  
Eric S. Bour ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Bariatric Surgery ◽  
Cost Effectiveness ◽  
Type Ii Diabetes ◽  
Cost Savings ◽  
Medical Costs ◽  
Type Ii Diabetes Mellitus ◽  
Morbidly Obese ◽  
Type Ii ◽  
The Cost

There has been considerable debate on the cost-effectiveness of bariatric surgery within larger population groups. Despite the recognition that morbid obesity and its comorbidities are best treated surgically, insurance coverage is not universally available. One of the more costly comorbidities of obesity is Type II diabetes mellitus (T2DM). We propose a model that demonstrates the cost-effectiveness of increasing the number of bariatric surgical operations performed on patients with T2DM in the United States. We applied published population cost estimates (2012) for medical care of T2DM to a retrospective cohort of morbidly obese patients in South Carolina. We compared differences in 10-year medical costs between those having bariatric surgery and controls. Resolution of T2DM in the bariatric cohort was assumed to be 40 per cent. Considering only the direct medical costs of T2DM, the 10-year aggregate cost savings compared with a control group is $2.7 million/1000 patients; the total (direct and indirect) cost savings is $5.4 million/1000 patients. When considering resolution of T2DM alone, increasing the number of bariatric operations for a given population leads to a substantial cost savings over a 10-year period. This study adds to the growing body of evidence suggesting that bariatric surgery is a cost-effective means of caring for the obese patient.

scholarly journals Does Age Modify the Cost-Effectiveness of Community-Based Physical Activity Interventions?

2015 ◽  
Vol 12 (2) ◽  
pp. 224-231 ◽  
Author(s):  
Larissa Roux ◽  
Mike Pratt ◽  
I-Min Lee ◽  
Terry Bazzarre ◽  
David Buchner
Keyword(s):  
Physical Activity ◽  
Cost Effectiveness ◽  
Cost Effective ◽  
Sensitivity Analyses ◽  
Age Group ◽  
Middle Aged ◽  
Community Based ◽  
Old Adults ◽  
The Cost ◽  
Middle Aged Adults

Background:Community-based efforts to promote physical activity (PA) in adults have been found to be cost-effective in general, but it is unknown if this is true in middle-age specifically. Age group-specific economic evaluations could help inform the design and delivery of better and more tailored PA promotion.Methods:A Markov model was developed to estimate the cost-effectiveness (CE) of 7 exemplar community-level interventions to promote PA recommended by the Guide to Community Preventive Services, over a 20-year horizon. The CE of these interventions in 25- to 64-year-old adults was compared with their CE in middle-aged adults, aged 50 to 64 years. The robustness of the results was examined through sensitivity analyses.Results:Cost/QALY (quality-adjusted life year) of the evaluated interventions in 25- to 64-year-olds ranged from $42,456/QALY to $145,868/QALY. Interventions were more cost-effective in middle-aged adults, with CE ratios 38% to 47% lower than in 25- to 64-year-old adults. Sensitivity analyses showed greater than a 90% probability that the true CE of 4 of the 7 interventions was below $125,000/QALY in adults aged 50 to 64 years.Conclusion:The exemplar PA promotion interventions evaluated appeared to be especially cost-effective for middle-aged adults. Prioritizing such efforts to this age group is a good use of societal resources.

Parents' Time Is Worth Money

PEDIATRICS ◽  
1983 ◽  
Vol 71 (3) ◽  
pp. 466-466
Author(s):  
DOUGLAS RICHARDSON
Keyword(s):  
Intensive Care ◽  
Cost Effectiveness ◽  
Economic Analysis ◽  
Bronchopulmonary Dysplasia ◽  
Neonatal Intensive Care ◽  
Waiting Times ◽  
Opportunity Costs ◽  
Home Management ◽  
Tacit Assumption ◽  
The Cost

To the Editor.— I was delighted to see Donn's letter about the cost effectiveness of home management of bronchopulmonary dysplasia.1 Such contributions are vital in helping to curb the rapidly rising costs of neonatal intensive care. However, his economic analysis is flawed. By tacit assumption, he omits any consideration of the opportunity costs to the parents. To omit this presumes that the parents' time is worth little or nothing, as we often seem to indicate by the long patient waiting times in our offices.

scholarly journals The effectiveness of health literacy oriented programs on physical activity behaviour in middle aged and older adults with type 2 diabetes: a systematic review

2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Michael Huen Sum Lam ◽  
Angela Yee Man Leung
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Older Adults ◽  
Health Literacy ◽  
Type Ii Diabetes ◽  
Physical Activity Behavior ◽  
Type Ii Diabetes Mellitus ◽  
Type Ii ◽  
Middle Aged ◽  
Activity Behavior

Health literacy is the first step to self-management of type II diabetes mellitus, of which physical activity is the least compliant behavior. However, no reviews have summarized the effect and the process of interventions of health literacy oriented programs on physical activity behavior among middle aged and older adults with type II diabetes mellitus. This article is the first to examine the effectiveness of health literacy oriented programs on physical activity behavior among middle aged and older adults with type II diabetes mellitus. This systematic review extracted articles from nine electronic databases between 1990 and 2013. Six interventional studies were extracted and reported in accordance with the guidance of Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Findings demonstrated that health literacy oriented programs increased the frequency and duration of physical activity among patients with high health literacy. Although some studies effectively improved the health literacy of physical activity, gap in literature remains open for the indistinct and unreliable measurement of physical activity within self-management programs of type II diabetes mellitus, and the questionable cross-culture generalizability of findings. Further studies with well-knit theorybased intervention with respect to patients’ cultural background, duration of intervention and objective measurements are encouraged to elucidate the relationship between health literacy oriented programs and physical activity behavior.

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