An economic model of the long-term health care burden of Type II diabetes

Bagust, A; Hopkinson, P.; Maier, W; Currie, Craig John

doi:10.1007/s001250100023

Cited by 95 publications

(83 citation statements)

References 22 publications

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“…Previous simulation models of the progression of diabetes have made a variety of assumptions regarding how risk factors such as HbA 1 c and systolic BP change over time [2,4]. While carrying forward current values provides a simple means of extrapolation [21,22], it does not account for the likely change in some of these risk factors over time (e.g.…”

Section: Methodsmentioning

confidence: 99%

“…They can also be used to estimate future healthcare costs of patients with Type 2 diabetes, but their main purpose is to estimate the cost-effectiveness of different disease management strategies, especially when evidence of the impact of interventions on surrogate endpoints is limited, or where evidence from clinical trials has to be extrapolated over patients' lifetimes. Currently, there are at least five simulation models being used in these ways [1,2,3,4,5].…”

Section: Introductionmentioning

confidence: 99%

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A model to estimate the lifetime health outcomes of patients with Type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model (UKPDS no. 68)

et al. 2004

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Aims/hypothesis. The aim of this study was to develop a simulation model for Type 2 diabetes that can be used to estimate the likely occurrence of major diabetes-related complications over a lifetime, in order to calculate health economic outcomes such as qualityadjusted life expectancy. Methods. Equations for forecasting the occurrence of seven diabetes-related complications and death were estimated using data on 3642 patients from the United Kingdom Prospective Diabetes Study (UKPDS). After examining the internal validity, the UKPDS Outcomes Model was used to simulate the mean difference in expected quality-adjusted life years between the UKPDS regimens of intensive and conventional blood glucose control. Results. The model's forecasts fell within the 95% confidence interval for the occurrence of observed events during the UKPDS follow-up period. When the model was used to simulate event history over patients' lifetimes, those treated with a regimen of conventional glucose control could expect 16.35 undiscounted quality-adjusted life years, and those receiving treatment with intensive glucose control could expect 16.62 quality-adjusted life years, a difference of 0.27 (95% CI: −0.48 to 1.03). Conclusions/interpretations. The UKPDS OutcomesModel is able to simulate event histories that closely match observed outcomes in the UKPDS and that can be extrapolated over patients' lifetimes. Its validity in estimating outcomes in other groups of patients, however, remains to be evaluated. The model allows simulation of a range of long-term outcomes, which should assist in informing future economic evaluations of interventions in Type 2 diabetes. The centres of the UKPDS are listed at the end of the paper Conflict of interest. Several authors (as indicated above) are employed by the University of Oxford. This paper describes and places in the public domain a simulation model that we have called the UKPDS Outcomes Model. All of the information necessary to reproduce the UKPDS Outcomes Model is provided in this article, but it is conceivable that a future user with a commercial interest in the UKPDS Outcomes Model might prefer to use the software already created by University programmers. Depending on the nature of the proposed use of the UKPDS Outcomes Model, the University of Oxford might charge a fee in this case.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A model to estimate the lifetime health outcomes of patients with Type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model (UKPDS no. 68)

et al. 2004

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“…To our knowledge, none of the published, diabetes diseasestate simulation models, [20][21][22][23][24][25][26][27][28][29][30][31][32][33] including the recently published UKPDS Outcomes Model 2, 34 takes into account currently available medical and surgical treatments. For the general population, various CHD policy models exist.…”

mentioning

confidence: 99%

The Michigan Model for Coronary Heart Disease in Type 2 Diabetes: Development and Validation

Brändle

Brown

et al. 2015

Diabetes Technology & Therapeutics

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Objectives: The aim of this study was to develop and validate a computer simulation model for coronary heart disease (CHD) in type 2 diabetes mellitus (T2DM) that reflects current medical and surgical treatments. Research Design and Methods: We modified the structure of the CHD submodel in the Michigan Model for Diabetes to allow for revascularization procedures before and after first myocardial infarction, for repeat myocardial infarctions and repeat revascularization procedures, and for congestive heart failure. Transition probabilities that reflect the direct effects of medical and surgical therapies on outcomes were derived from the literature and calibrated to recently published population-based epidemiologic studies and randomized controlled clinical trials. Monte Carlo techniques were used to implement a discrete-state and discrete-time multistate microsimulation model. Performance of the model was assessed using internal and external validation. Simple regression analysis (simulated outcome = b 0 + b 1 · published outcome) was used to evaluate the validation results. Results: For the 21 outcomes in the six studies used for internal validation, R 2 was 0.99, and the slope of the regression line was 0.98. For the 16 outcomes in the five studies used for external validation, R 2 was 0.81, and the slope was 0.84. Conclusions: Our new computer simulation model predicted the progression of CHD in patients with T2DM and will be incorporated into the Michigan Model for Diabetes to assess the cost-effectiveness of alternative strategies to prevent and treat T2DM.

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“…Raikou and McGuire 71 appear to have missed the study by Bagust and colleagues, 73 which reports the creation of a model, and the results from running it, for T2DM. The model appears well thought out and inevitably complex.…”

Section: The Costs Of Diabetesmentioning

confidence: 99%

Screening for type 2 diabetes: literature review and economic modelling

2007

Clinical Governance: An International Journal

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An economic model of the long-term health care burden of Type II diabetes

Cited by 95 publications

References 22 publications

A model to estimate the lifetime health outcomes of patients with Type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model (UKPDS no. 68)

A model to estimate the lifetime health outcomes of patients with Type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model (UKPDS no. 68)

The Michigan Model for Coronary Heart Disease in Type 2 Diabetes: Development and Validation

Screening for type 2 diabetes: literature review and economic modelling

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