An economic value of the glycated hemoglobin test in diabetes mellitus type 2 diagnosis

Shestakova, Marina Vladimirovna; Kolbin, A. S.; Карпов, О. И.; Galstyan, Gagik R.; Mayorov, Alexander Y.; Arepeva, Maria A.; Kurylev, A. A.; Проскурин, М. А.

doi:10.14341/dm12205

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“…Если <7 -скрининг не нужен, но если возраст находится в пределах пороговых значений, необходимо динамическое наблюдение. Скрининг предпочтительнее осуществлять с определением HbA 1c , что является клинически и экономически обоснованным [7].…”

Section: результатыunclassified

“…По сути, диабетология -отрасль медицины, способная многократно сохранять общественные и материальные ресурсы при своевременной диагностике и достижении целевого уровня контроля заболевания. Примененный нами в исследовании NATION способ выявления больных с помощью теста на гликированный гемоглобин (HbA 1c ), обладающий высокой специфичностью и информативностью [6], показавший экономическую целесообразность внедрения [7], все же, по нашему убеждению, на данном этапе для первичной диагностики будет целесообразен не во всей популяции взрослых, а у группы риска по развитию СД2.…”

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«DIARISK» — the first national prediabetes and diabetes mellitus type 2 risk calculator

et al. 2021

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BACKGRAUND: The need to create a national questionnaire for screening the population for disorders of carbohydrate metabolism.AIMS: Develop a highly specific and sensitive questionnaire-calculator of the risk of prediabetes (PreD) and diabetes mellitus type 2 (DM2T) based on depersonalized data of individuals who have these diagnoses confirmed in the national epidemiological study NATION.METHODS: The express method of prediabetes (PreD) and diabetes mellitus type 2 (DM2T) risks has been created, validated and proposed for clinical usage for the first time in the Russian Federation, it was based of NATION epidemiologic study database (more than 26 000 participants). The following mathematical instruments have been used: mathematic modelling, main components methodology, binary variables, correlation analysis and single-factor analysis of variance.RESULTS: Highest coefficients of logistic regression for PreD (p<0.05) were identified for age — ≥52 years old for women and ≥59 years old for men (1,48); body mass index ≥31 (0.75); waist circumference ≥100 сm for women and ≥112 cm for men (0.90). In the same time coefficients for DM2T were for for age — ≥52 years old for women and ≥59 years old for men (1,24); body mass index ≥31 (1,19), high blood fasting glucose analysis in the past (1,37); waist circumference / hip circumference ratio ≥0.85 for women and ≥0.92 for men (1,05), high blood pressure (0.69). Correlation coefficients were taken into account and score has been used for specialized questionnaire creation. Sensitivity and specificity for PreD were 83,8% and 59,3% accordingly, for DM2T — 85,4% and 73,6% accordingly. DM2T may be suspected when total score of questionnaire is 11 and higher, and PreD — when total score will be ≥7 and <11.CONCLUSIONS: The calculator based on questionnaire (DIARISK) allows to separate of potential patient for PreD and DM2T confirmation during first examination or dispanserization. A patent for innovation has been issued.

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«DIARISK» — the first national prediabetes and diabetes mellitus type 2 risk calculator

et al. 2021

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“…Именно этот уровень признаётся необходимым для достижения в процессе лечения, поскольку при таких параметрах углеводного обмена снижается риск сердечно-сосудистых осложнений (ИБС, острого инфаркта миокарда, острого нарушения мозгового кровообращения и др.). Эти осложнения являются ресурсоёмкими, о необходимости их предупреждения для уменьшения общественных и бенефициарных потерь имеются многочисленные доказательства как в отечественной, так и в зарубежной практике [2][3][4][5].…”

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The pharmacoeconomic comparison of the fixed insulin glargine and lixisenatide combination with insulin degludec family in type 2 diabetes mellitus

Дьяков¹,

Зырянов

2021

GCP

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Insulin glargine 100 U/ml (iGla) is gradually giving way to a fixed combination of insulin glargine 100 U/ml+ lixisenatide (iGlaLixi) — an effective and safe drug for Diabetes Mellitus Type 2 (DM2T) control. It has demonstrated the economic benefits in naïve patients as well as for treatment intensification aft er failure of insulins. Economic aspects of iGlaLixi in DM2T in comparison with another effective drugs — insulin degludec (iDeg) and insulin degludec + insulin aspart (iDegAsp) were not evaluated before.Materials and methods. Indirect treatment comparison (ITC) for iGlaLixi with others EDL drugs — iDeg and iDegAsp — has been performed through common comparator — iGla based on published results of efficacy in naïve and insulinized DM2T patients separately. Patients reached target HbA1c level (%) were chosen as a criterion of drugs efficacy. Odds ratio (OR) of efficacy has been calculated, modelling has been performed for direct and indirect costs. Sensitivity analysis was done for validation of results.Results. Efficacy of iGlaLixi were higher as well in naïve as in insulinized patients in comparison with iDeg family: with iDeg comparison OR 2.23 (95 % CI 1.40; 3.53); 3.34 (2.06; 5.40), with iDegAsp OR 1.90 (1.23; 2.95) и 2.49 (1.54; 4.04) accordingly. Direct costs in sum for iGlaLixi were less for iDeg on 22.1, and on 18.3 % for iDegAsp in naïve patient group, and on 35.9 % and 7.0 % for insulinized patients respectively. In total expenditures (direct and indirect costs) for iGlaLixi were less vs iDeg and iDegAsp for naïve patients on 18.9 % and 28 %, and on 15.5 % and 8.9 % for insulinized patients accordingly for 26 weeks treatment. Sensitivity analysis has confirmed of results.Conclusion. iGlaLixi has economic benefits vs iDeg and iGedAsp for DM2T treatment.

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Pharmacoeconomic characteristics of agonists of receptors for glucagon-like peptide-1 and medicines on their base

Дьяков

Зырянов

2021

GCP

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The effective control of Diabetes Mellitus (DM) is an actual problem from optimal expenditures of health care system point of view. Agonists of receptors for glucagon like peptide-1 (aGLP-1) are one of the modern option for glycemia control in DM Type 2 and included in all current guidelines for the treatment control. The economic comparative aspects of the use of these drugs in the local conditions have not been studied. Materials and methods. Comparative economic evaluation of insulin glargine + lixisenatide (iGlaLixi), exenatide (Exe), dulaglutide (Dula), liraglutide (Lira) and combinations of their aGLP-1 with iGla 100 U has been performed base on published clinical data of efficacy. Number of patients with HbA1c <7 % was chosen as efficacy criterion. Non-direct comparison with Odds Ratio (OR) calculation was prepared. Direct and indirect costs (medications, treatment of CV-complications, GDP loses etc.) were indicated and calculated based on constructed model. Sensitivity analysis has been provided for validation of results. Results. Pharmacoeconomic analysis based on non-direct efficacy comparisons of iGlaLixi, Exe, Lira and Dula has shown of economic advantages of effective DM2T control. iGlaLixi has demonstrated economic advantages as well usage aGLP-1 only (direct costs decreasing vs Exe on 23,8 %, vs Dula on 15,6 %, vs Lira on 54,4 %) as their combinations with iGla 100 U (direct costs decreasing vs iGla 100 U + Exe on 23,8 %, vs iGla 100 U + Dula on 15,2 %). iGlaLixi decreased a total cost (direct and non-direct) better than Exe, Dula and Lira (on 19,9, 9,3 и 45,2 % accordingly). Conclusion. An effective control of DM2T with aGLP-1 and medicines on their base has an economic value because lead to expenditures for complications decreasing from government position.

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An economic value of the glycated hemoglobin test in diabetes mellitus type 2 diagnosis

Cited by 4 publications

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«DIARISK» — the first national prediabetes and diabetes mellitus type 2 risk calculator

«DIARISK» — the first national prediabetes and diabetes mellitus type 2 risk calculator

The pharmacoeconomic comparison of the fixed insulin glargine and lixisenatide combination with insulin degludec family in type 2 diabetes mellitus

Pharmacoeconomic characteristics of agonists of receptors for glucagon-like peptide-1 and medicines on their base

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