Clinical and economic characteristics associated with type 2 diabetes

Sicras‐Mainar, Antoni; Navarro‐Artieda, Ruth; Ibáñez-Nolla, Jordi

doi:10.1016/j.rceng.2014.01.001

Cited by 10 publications

(32 citation statements)

References 35 publications

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“…In Spain, the prevalence of T2DM ranges from 10 to 15% [3][4][5], increasing progressively as age increases, and reaching 23.1% in the 70-74 years age group [6].…”

Section: Methodsmentioning

confidence: 99%

“…Hence, T2DM is one of the most important chronic diseases, with great socioeconomic impact in Spain, not only because of its high prevalence but also because of the acute and chronic complications that occur, which constitute the first cause of years lived with disability (YLD), and because of its high mortality rate [10]. Furthermore, T2DM poses a high economic burden for the National Health System (NHS), with an estimated average cost per patient of €4458 after 2 years [5].…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Cost-Effectiveness Analysis of Exenatide versus GLP-1 Receptor Agonists in Patients with Type 2 Diabetes Mellitus

Capel

Ciudin

Mareque

et al. 2019

PharmacoEconomics Open

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Objective The aim of this study was to assess the efficiency of exenatide 2 mg/week compared with other glucagon-like peptide-1 (GLP-1) receptor agonists (dulaglutide 1.5 mg/week, liraglutide 1.2 mg/day, liraglutide 1.8 mg/day and lixisenatide 20 μg/day) in adult patients with type 2 diabetes mellitus (T2DM) not adequately controlled on metformin alone from the perspective of the Spanish National Health System (NHS). Methods Quality-adjusted life-years (QALYs) gained and total costs of each assessed drug combined with metformin (2 g/ day) were estimated over a 40-year time horizon using the Cardiff Diabetes Model (based on UK Prospective Diabetes Study [UKPDS] 68 equations), which simulates disease progression considering the T2DM-related micro-and macrovascular complications, hypoglycaemia, nausea, body mass index (BMI) changes and treatment discontinuation due to adverse effects (AEs). Drug efficacy derived from an indirect comparison performed in a network meta-analysis. Patient characteristics were obtained from the literature. The baseline utility value (0.80) was derived from the PANORAMA study, applying utility decrements to micro-and macrovascular complications, hypoglycaemia episodes and changes in BMI. Treatment discontinuation due to AEs or poorly controlled diabetes (HbA1c > 7.5%) involved switching to second-line (basal insulin) or third-line (basal-bolus insulin) treatment. Total cost (€, 2018) included the costs of drug acquisition, hypoglycaemia, weight gain, micro-and macrovascular complications, nausea and treatment discontinuation due to AEs. An annual discount rate of 3% was applied to costs and outcomes. Deterministic and probabilistic sensitivity analyses (SA) were performed. Results In base-case, exenatide 2 mg/week resulted in more QALYs (8.26) than dulaglutide 1.5 mg/week (8.19 QALYs), liraglutide 1.2 mg/day (8.10 QALYs), liraglutide 1.8 mg/day (8.20 QALYs) and lixisenatide 20 μg/day (8.13 QALYs). Total cost/patient was €20,423.27 (exenatide 2 mg/week), €22,611.94 (dulaglutide 1.5 mg/week), €21,065.97 (liraglutide 1.2 mg/ day), €24,865.69 (liraglutide 1.8 mg/day) and €21,334.58 (lixisenatide 20 μg/day). Deterministic SA confirmed the robustness of the model. In the probabilistic SA, 95-99% of the 1000 Monte Carlo iterations performed were under a hypothetical willingness-to-pay threshold of €20,000/QALY gained. Conclusions Exenatide 2 mg/week would be a dominant strategy (more effective and less costly) versus the other GLP-1 receptor agonists assessed for the treatment of T2DM patients who are not adequately controlled on metformin alone.

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“…In Spain, the prevalence of T2DM ranges from 10 to 15% [3][4][5], increasing progressively as age increases, and reaching 23.1% in the 70-74 years age group [6].…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Cost-Effectiveness Analysis of Exenatide versus GLP-1 Receptor Agonists in Patients with Type 2 Diabetes Mellitus

Capel

Ciudin

Mareque

et al. 2019

PharmacoEconomics Open

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“…Studies show that complications and comorbidities increase healthcare resource use (HRU) including hospitalization, medication administered, productivity losses, etc., which result in increased costs associated with T2DM 1,2,6 . In Spain, the mean annual cost per patient with T2DM ranges between e1000 and e6000 [9][10][11][12][13][14][15][16][17] . However, the time of measurement, the cost components included, the perspective of the financer/society, and other aspects mentioned above may vary between studies hindering comparability 14 .…”

Section: Introductionmentioning

confidence: 99%

Resource use and costs in patients with poorly controlled type 2 diabetes mellitus and obesity in routine clinical practice in Spain

Díaz‐Cerezo

Romera

Sicras‐Mainar

et al. 2020

Current Medical Research and Opinion

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Objective: To compare healthcare resource use (HRU) and annual costs in type 2 diabetes mellitus (T2DM) patients with poor glycaemic control and obesity versus good glycaemic control without obesity. Methods: Observational retrospective study based on the analysis of electronic medical records from the BIG-PAC database, with one year of follow-up. T2DM patients aged 30 years who requested medical care during 2013 were included. Annual HRU and costs per patient were compared between a reference group (HbA1c 8%, BMI 30 kg/m 2 , receiving 2 oral antidiabetic drugs [OADs]) and a control group (HbA1c < 7% and BMI <30 kg/m 2 ). Direct and indirect costs (lost productivity) were analysed. Cost comparisons across groups were made using the analysis of covariance (ANCOVA) for each cost component, with age, sex, time from diagnosis, Charlson comorbidity index, OAD number and sex by group interaction as covariates.Results: During the follow-up, patients in the reference group (N ¼ 2709) had a greater HRU than those in the control group (N ¼ 5266), especially in the number of primary care (PC) visits (11.8 vs. 9.8;

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“…Obesity is considered to be the major risk factor for type 2 diabetes mellitus (T2DM) development, the estimated prevalence of which was 8.5% in Europe in 2013, while this population continues to develop diabetic macro-and microvascular complications resulting in increased disability and enormous healthcare costs 1,2 . Several study reports suggest that fat distribution is important as a risk factor for T2DM development, i.e.…”

Section: Introductionmentioning

confidence: 99%

The Use of Anthropometric Measurements of Obesity in Prediction of Microvascular Complications in Obese Type 2 Diabetic Patients

Bulum

Blaslov

Duvnjak

2016

ACC

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SUMMARY -Waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) are superior to body mass index (BMI) in predicting type 2 diabetes mellitus (T2DM) development. Th e aim of this study was to investigate the predictive power of BMI, WC, WHR and WHtR for microvascular (chronic kidney disease (CKD), retinopathy and peripheral neuropathy) prevalence in obese (BMI ≥35 kg/m 2 ) T2DM patients. Th is cross-sectional study included 125 T2DM patients of both genders. Th e validity of each test was assessed by Receiver Operating Characteristic (ROC) curves; the area under the curve (AUC) was calculated for each anthropometric parameter and microvascular complication. AUCs for WHtR were signifi cantly higher than AUCs for WC with respect to CKD. Optimal cut-off for WHtR was >0.593 and WC >112 cm regarding CKD. Th e AUC for peripheral neuropathy was signifi cant only for WHR and optimal cut-off for WHR was >1.409 with low sensitivity and high specifi city. Our study demonstrated that WHtR, WC and WHR might be used as simple and noninvasive methods for detection of CKD and peripheral neuropathy in obese T2DM population.

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Clinical and economic characteristics associated with type 2 diabetes

Cited by 10 publications

References 35 publications

Cost-Effectiveness Analysis of Exenatide versus GLP-1 Receptor Agonists in Patients with Type 2 Diabetes Mellitus

Cost-Effectiveness Analysis of Exenatide versus GLP-1 Receptor Agonists in Patients with Type 2 Diabetes Mellitus

Resource use and costs in patients with poorly controlled type 2 diabetes mellitus and obesity in routine clinical practice in Spain

The Use of Anthropometric Measurements of Obesity in Prediction of Microvascular Complications in Obese Type 2 Diabetic Patients

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