scholarly journals Economic evaluation of population-based type 2 diabetes mellitus screening at different healthcare settings in Vietnam

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261231
Author(s):  
Phung Lam Toi ◽  
Olivia Wu ◽  
Montarat Thavorncharoensap ◽  
Varalak Srinonprasert ◽  
Thunyarat Anothaisintawee ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cost Effectiveness ◽  
Cost Effective ◽  
Economic Evaluations ◽  
Value For Money ◽  
Healthcare Settings ◽  
Annual Screening

Introduction Few economic evaluations have assessed the cost-effectiveness of screening type-2 diabetes mellitus (T2DM) in different healthcare settings. This study aims to evaluate the value for money of various T2DM screening strategies in Vietnam. Methods A decision analytical model was constructed to compare costs and quality-adjusted life years (QALYs) of T2DM screening in different health care settings, including (1) screening at commune health station (CHS) and (2) screening at district health center (DHC), with no screening as the current practice. We further explored the costs and QALYs of different initial screening ages and different screening intervals. Cost and utility data were obtained by primary data collection in Vietnam. Incremental cost-effectiveness ratios were calculated from societal and payer perspectives, while uncertainty analysis was performed to explore parameter uncertainties. Results Annual T2DM screening at either CHS or DHC was cost-effective in Vietnam, from both societal and payer perspectives. Annual screening at CHS was found as the best screening strategy in terms of value for money. From a societal perspective, annual screening at CHS from initial age of 40 years was associated with 0.40 QALYs gained while saving US$ 186.21. Meanwhile, one-off screening was not cost-effective when screening for people younger than 35 years old at both CHS and DHC. Conclusions T2DM screening should be included in the Vietnamese health benefits package, and annual screening at either CHS or DHC is recommended.

scholarly journals A systematic review of economic evaluations in non-insulin antidiabetic treatments for patients with type 2 diabetes mellitus

2019 ◽  
Vol 2019 ◽  
pp. 228424031987657 ◽  
Author(s):  
Néboa Zozaya ◽  
Margarita Capel ◽  
Susana Simón ◽  
Alfonso Soto-González
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Management Strategies ◽  
Cost Effective ◽  
Cost Utility ◽  
Economic Evaluations ◽  
Life Years ◽  
Comparative Results

The approval of new non-insulin treatments has broadened the therapeutic arsenal, but it has also increased the complexity of choice for the treatment of type 2 diabetes mellitus (DM2). The objective of this study was to systematically review the literature on economic evaluations associated with non-insulin antidiabetic drugs (NIADs) for DM2. We searched in Medline, IBECS, Doyma and SciELO databases for full economic evaluations of NIADs in adults with DM2 applied after the failure of the first line of pharmacological treatment, published between 2010 and 2017, focusing on studies that incorporated quality-adjusted life years (QALYs). The review included a total of 57 studies, in which 134 comparisons were made between NIADs. Under an acceptability threshold of 25,000 euros per QALY gained, iSLGT-2 were preferable to iDPP-4 and sulfonylureas in terms of incremental cost-utility. By contrast, there were no conclusive comparative results for the other two new NIAD groups (GLP-1 and iDPP-4). The heterogeneity of the studies’ methodologies and results hindered our ability to determine under what specific clinical assumptions some NIADs would be more cost-effective than others. Economic evaluations of healthcare should be used as part of the decision-making process, so multifactorial therapeutic management strategies should be established based on the patients’ clinical characteristics and preferences as principal criteria.

scholarly journals Cost-effectiveness of insulin degludec versus insulin glargine U100 in adults with type 1 and type 2 diabetes mellitus in Bulgaria

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Monika Russel-Szymczyk ◽  
Vasil Valov ◽  
Alexandra Savova ◽  
Manoela Manova
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cost Effectiveness ◽  
Insulin Glargine ◽  
Cost Effective ◽  
Insulin Degludec ◽  
The Cost

Abstract Background This analysis evaluates the cost-effectiveness of insulin degludec (degludec) versus biosimilar insulin glargine U100 (glargine U100) in patients with type 1 (T1DM) and type 2 diabetes mellitus (T2DM) in Bulgaria. Methods A simple, short-term model was used to compare the treatment costs and outcomes associated with hypoglycaemic events with degludec versus glargine U100 in patients with T1DM and T2DM from the perspective of the Bulgarian National Health Insurance Fund. Cost-effectiveness was analysed over a 1-year time horizon using data from clinical trials. The incremental cost-effectiveness ratio (ICER) was the main outcome measure. Results In Bulgaria, degludec was highly cost-effective versus glargine U100 in people with T1DM and T2DM. The ICERs were estimated to be 4493.68 BGN/quality-adjusted life year (QALY) in T1DM, 399.11 BGN/QALY in T2DM on basal oral therapy (T2DMBOT) and 7365.22 BGN/QALY in T2DM on basal bolus therapy (T2DMB/B), which are below the cost-effectiveness threshold of 39,619 BGN in Bulgaria. Degludec was associated with higher insulin costs in all three patient groups; however, savings from a reduction in hypoglycaemic events with degludec versus glargine U100 partially offset these costs. Sensitivity analysis demonstrated that the results were robust and largely insensitive to variations in input parameters. At a willingness-to-pay threshold of 39,619 BGN/QALY, the probability of degludec being cost-effective versus glargine U100 was 60.0% in T1DM, 99.4% in T2DMBOT and 91.3% in T2DMB/B. Conclusion Degludec is a cost-effective alternative to biosimilar glargine U100 for patients with T1DM and T2DM in Bulgaria. Degludec could be of particular benefit to those patients suffering recurrent hypoglycaemia and those who require additional flexibility in the dosing of insulin.

scholarly journals Cost-effectiveness of insulin degludec versus insulin glargine U100 in adults with type 1 and type 2 diabetes mellitus in Bulgaria

2019 ◽  
Author(s):  
Monika Russel-Szymczyk ◽  
Vasil Valov ◽  
Alexandra Savova ◽  
Manoela Manova
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cost Effectiveness ◽  
Insulin Glargine ◽  
Cost Effective ◽  
Insulin Degludec ◽  
The Cost

Abstract Background This study investigates the cost-effectiveness of insulin degludec (degludec) versus biosimilar insulin glargine U100 (glargine U100) in patients with type 1 (T1DM) and type 2 diabetes mellitus (T2DM) in Bulgaria.Methods A simple, short-term model was used to compare the treatment costs and outcomes associated with hypoglycaemic events with degludec versus glargine U100 in patients with T1DM and T2DM from the perspective of the Bulgarian National Health Insurance Fund. Cost-effectiveness was analysed over a 1-year time horizon using data from clinical trials. The outcome measure was the incremental cost-effectiveness ratio (ICER).Results Degludec was highly cost-effective versus glargine U100 in people with T1DM and T2DM in Bulgaria. The ICERs were estimated to be 4,493.68 BGN/quality-adjusted life year (QALY) in T1DM, 399.11 BGN/QALY in T2DM on basal oral therapy (T2DM BOT ) and 7,365.22 BGN/QALY in T2DM on basal bolus therapy (T2DM B/B ), which all fall below the cost-effectiveness threshold of 39,619 BGN in Bulgaria. Insulin costs were higher with degludec in all three patient groups, however these were partially offset by savings from a reduction in hypoglycaemic events with degludec versus glargine U100. Sensitivity analysis demonstrated that the results were robust and largely insensitive to variations in input parameters. At a willingness-to-pay threshold of 39,619 BGN/QALY, the probability of degludec being cost-effective versus glargine U100 was 60.0% in T1DM, 99.4% in T2DM BOT and 91.3% in T2DM B/B .Conclusion Degludec is a cost-effective alternative to biosimilar glargine U100 for patients with T1DM and T2DM in Bulgaria. Degludec could be of particular benefit to those patients suffering recurrent hypoglycaemia and those who require additional flexibility in the dosing of insulin.

scholarly journals Value For Money In The Treatment Of Patients With Type 2 Diabetes Mellitus: Assessing The Long-Term Cost-Effectiveness Of IDegLira Versus iGlarLixi In Italy

2019 ◽  
Vol Volume 11 ◽  
pp. 605-614 ◽  
Author(s):  
Johannes Pöhlmann ◽  
Roberta Montagnoli ◽  
Giusi Lastoria ◽  
Witesh Parekh ◽  
Marie Markert ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cost Effectiveness ◽  
P Value ◽  
Value For Money

scholarly journals Cost-effectiveness of insulin degludec versus insulin glargine U100 in adults with type 1 and type 2 diabetes mellitus in Bulgaria

2019 ◽  
Author(s):  
Monika Russel-Szymczyk ◽  
Vasil Valov ◽  
Alexandra Savova ◽  
Manoela Manova
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cost Effectiveness ◽  
Insulin Glargine ◽  
Cost Effective ◽  
Insulin Degludec ◽  
The Cost

Abstract Background This study investigates the cost-effectiveness of insulin degludec (degludec) versus biosimilar insulin glargine U100 (glargine U100) in patients with type 1 (T1DM) and type 2 diabetes mellitus (T2DM) in Bulgaria.Methods A simple, short-term model was used to compare the treatment costs and outcomes associated with hypoglycaemic events with degludec versus glargine U100 in patients with T1DM and T2DM from the perspective of the Bulgarian National Health Insurance Fund. Cost-effectiveness was analysed over a 1-year time horizon using data from clinical trials. The outcome measure was the incremental cost-effectiveness ratio (ICER).Results Degludec was highly cost-effective versus glargine U100 in people with T1DM and T2DM in Bulgaria. The ICERs were estimated to be 4,493.68 BGN/quality-adjusted life year (QALY) in T1DM, 399.11 BGN/QALY in T2DM on basal oral therapy (T2DM BOT ) and 7,365.22 BGN/QALY in T2DM on basal bolus therapy (T2DM B/B ), which all fall below the cost-effectiveness threshold of 39,619 BGN in Bulgaria. Insulin costs were higher with degludec in all three patient groups, however these were partially offset by savings from a reduction in hypoglycaemic events with degludec versus glargine U100. Sensitivity analysis demonstrated that the results were robust and largely insensitive to variations in input parameters. At a willingness-to-pay threshold of 39,619 BGN/QALY, the probability of degludec being cost-effective versus glargine U100 was 60.0% in T1DM, 99.4% in T2DM BOT and 91.3% in T2DM B/B .Conclusion Degludec is a cost-effective alternative to biosimilar glargine U100 for patients with T1DM and T2DM in Bulgaria. Degludec could be of particular benefit to those patients suffering recurrent hypoglycaemia and those who require additional flexibility in the dosing of insulin.

scholarly journals Cost and cost-effectiveness of mHealth interventions for the prevention and control of type 2 diabetes mellitus: a protocol for a systematic review

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e027490 ◽  
Author(s):  
Giulia Rinaldi ◽  
Alexa Hijazi ◽  
Hassan Haghparast-Bidgoli
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cost Effectiveness ◽  
Economic Evaluations ◽  
Quality Of Reporting ◽  
The Cost

IntroductionType 2 diabetes mellitus (T2DM) remains one of the most common chronic diseases of adulthood which creates high degrees of morbidity and mortality worldwide. The incidence of T2DM continues to rise and recently, mHealth interventions have been increasingly used in the prevention, monitoring and management of T2DM. The aim of this study is to systematically review the published evidence on cost and cost-effectiveness of mHealth interventions for T2DM, as well as assess the quality of reporting of the evidence.Methods and analysisA comprehensive review of PubMed, EMBASE, Science Direct and Web of Science of articles published until January 2019 will be conducted. Included studies will be partial or full economic evaluations which provide cost or cost-effectiveness results for mHealth interventions targeting individuals diagnosed with, or at risk of, T2DM. The quality of reporting evidence will be assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Results will be presented using a flowchart following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines. Graphical and tabulated representations of the results will be created for both descriptive and numerical results. The cost and cost-effectiveness values will be presented as reported by the original studies as well as converted into international dollars to allow comparability. As we are predicting heterogenous results, we will conduct a narrative and interpretive analysis of the data.Ethics and disseminationNo formal approval or review of ethics is required for this systematic review as it will involve the collection and analysis of secondary data. This protocol follows the current PRISMA-P guidelines. The review will provide information on the cost and cost-effectiveness of mHealth interventions targeting T2DM. These results will be disseminated through publication and submission to conferences for presentations and posters.PROSPERO registration numberCRD42019123476

scholarly journals Metformin Use and Vitamin B12 Deficiency in Patients with Type-2 Diabetes Mellitus

2016 ◽  
Vol 3 (1) ◽  
pp. 67 ◽  
Author(s):  
Singh Jeetendra ◽  
Baheti Tushar
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Megaloblastic Anemia ◽  
Serum Vitamin ◽  
Cost Effective ◽  
Vitamin B ◽  
Average Dose ◽  
Annual Screening

Metformin is commonly used oral hypoglycaemic agent in the treatment of type-2 Diabetes Mellitus (DM). One of the important side effect of long term metformin therapy is malabsorption of vitamin B<sub>12</sub> which could lead to megaloblastic anemia and peripheral neuropathy. Therefore annual screening of serum vitamin B<sub>12</sub> level or serum methylmalonic acid (MMA)/serum homocysteine level should be done in cases taking metformin for more than four to five years with average dose of &gt;1g per day, even in the absence of haematological or neurological abnormalities. However, as the incidence of type-2 DM is increasing, cost of annual measurement of vitamin B<sub>12</sub> level also increases. Considering cost factor for annual screening, vitamin B<sub>12</sub> supplementation appears to be more cost effective approach rather than annual screening for routine prophylaxis. Routine vitamin preparations available in the market may contain less amount of B<sub>12</sub> and hence are not of much therapeutic use in treatment of B<sub>12</sub> deficiency due to Metformin. Hence there is a need to look for higher doses of approximately 500-2000μg/day.

scholarly journals Cost-effectiveness of insulin degludec versus insulin glargine U100 in adults with type 1 and type 2 diabetes mellitus in Bulgaria

2019 ◽  
Author(s):  
Monika Russel-Szymczyk ◽  
Vasil Valov ◽  
Alexandra Savova ◽  
Manoela Manova
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cost Effectiveness ◽  
Insulin Glargine ◽  
Cost Effective ◽  
Insulin Degludec ◽  
The Cost

Abstract Background This study investigates the cost-effectiveness of insulin degludec (degludec) versus biosimilar insulin glargine U100 (glargine U100) in patients with type 1 (T1DM) and type 2 diabetes mellitus (T2DM) in Bulgaria.Methods A simple, short-term model was used to compare the treatment costs and outcomes associated with hypoglycaemic events with degludec versus glargine U100 in patients with T1DM and T2DM from the perspective of the Bulgarian National Health Insurance Fund. Cost-effectiveness was analysed over a 1-year time horizon using data from clinical trials. The outcome measure was the incremental cost-effectiveness ratio (ICER).Results Degludec was highly cost-effective versus glargine U100 in people with T1DM and T2DM in Bulgaria. The ICERs were estimated to be 4,493.68 BGN/quality-adjusted life year (QALY) in T1DM, 399.11 BGN/QALY in T2DM on basal oral therapy (T2DM BOT ) and 7,365.22 BGN/QALY in T2DM on basal bolus therapy (T2DM B/B ), which all fall below the cost-effectiveness threshold of 39,619 BGN in Bulgaria. Insulin costs were higher with degludec in all three patient groups, however these were partially offset by savings from a reduction in hypoglycaemic events with degludec versus glargine U100. Sensitivity analysis demonstrated that the results were robust and largely insensitive to variations in input parameters. At a willingness-to-pay threshold of 39,619 BGN/QALY, the probability of degludec being cost-effective versus glargine U100 was 60.0% in T1DM, 99.4% in T2DM BOT and 91.3% in T2DM B/B .Conclusion Degludec is a cost-effective alternative to biosimilar glargine U100 for patients with T1DM and T2DM in Bulgaria. Degludec could be of particular benefit to those patients suffering recurrent hypoglycaemia and those who require additional flexibility in the dosing of insulin.

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