Economic Simulation Modeling in Type 2 Diabetes

Dadwani, Rahul; Laiteerapong, Neda

doi:10.1007/s11892-020-01306-y

Cited by 8 publications

(10 citation statements)

References 49 publications

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“…For people of Asian ethnicity, kidney disease was shown to be a more likely consequence of T2DM than for European and US populations [154], while SGTL2 inhibitors, as an add-on to metformin, were shown to be more efficacious in East Asian patients relative to non-Asian patients with T2DM [155]. These epidemiological and physiological differences in populations with diabetes and/or CKD have led to calls for modeling that is more sensitive to these differences [156], which have recently been heeded as a number of models have been developed specifically for Asian settings using data not derived from US or European populations. In Fig.…”

Section: Discussionmentioning

confidence: 99%

Modeling Chronic Kidney Disease in Type 2 Diabetes Mellitus: A Systematic Literature Review of Models, Data Sources, and Derivation Cohorts

Pöhlmann¹,

Bergenheim

Sánchez

et al. 2022

Diabetes Ther

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Introduction: As novel therapies for chronic kidney disease (CKD) in type 2 diabetes mellitus (T2DM) become available, their long-term benefits should be evaluated using CKD progression models. Existing models offer different modeling approaches that could be reused, but it may be challenging for modelers to assess commonalities and differences between the many available models. Additionally, the data and underlying population characteristics informing model parameters may not always be evident. Therefore, this study reviewed and summarized existing modeling approaches and data sources for CKD in T2DM, as a reference for future model development.Methods: This systematic literature review included computer simulation models of CKD in T2DM populations. Searches were implemented in PubMed (including MEDLINE), Embase, and the Cochrane Library, up to October 2021. Models were classified as cohort state-transition models (cSTM) or individual patient simulation (IPS) models. Information was extracted on modeled kidney disease states, risk equations for CKD, data sources, and baseline characteristics of derivation cohorts in primary data sources. Results: The review identified 49 models (21 IPS, 28 cSTM). A five-state structure was standard among state-transition models, comprising one kidney disease-free state, three kidney disease states [frequently including albuminuria and end-stage kidney disease (ESKD)], and one death state. Five models captured CKD regression and three included cardiovascular disease (CVD). Risk equations most commonly predicted albuminuria and ESKD incidence, while the most predicted CKD sequelae were mortality and CVD. Most data sources were

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Section: Discussionmentioning

confidence: 99%

Modeling Chronic Kidney Disease in Type 2 Diabetes Mellitus: A Systematic Literature Review of Models, Data Sources, and Derivation Cohorts

Pöhlmann¹,

Bergenheim

Sánchez

et al. 2022

Diabetes Ther

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“…First, there is an issue of generalizability to more ethnically diverse populations and different ethnic groups given how 83% of the UKPDS participants had European ethnicity with a median age of 54 years (IQR 48–60 years) [ 31 ]. Second, there is a likelihood that treatment regimes evaluated in the study may not correspond to current practice [ 1 , 46 ]. Further, exposure to risk factors, disease incidence, and standards of care for T2D are also likely to be notably different now compared to when the original study was conducted (1977-1997).…”

Section: Discussionmentioning

confidence: 99%

“…When either developing a new model or adapting/recalibrating an existing one, the availability of reliable and applicable data is key. The scarcity of robust T2D data from LMIC populations continues to be a major hindrance in conducting model-based analyses that focuses on these populations [ 42 , 46 ]. There are other data requirements for model-based analyses which include baseline patient characteristics of the simulated cohort, clinical effectiveness data, utility data and resource use (cost) data.…”

Section: Discussionmentioning

confidence: 99%

A review of simulation models for the long-term management of type 2 diabetes in low-and-middle income countries

Mukonda

Cleary

Lesosky

2021

BMC Health Serv Res

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Introduction The burden of type 2 diabetes is steadily increasing in low-and-middle-income countries, thereby posing a major threat from both a treatment, and funding standpoint. Although simulation modelling is generally relied upon for evaluating long-term costs and consequences associated with diabetes interventions, no recent article has reviewed the characteristics and capabilities of available models used in low-and-middle-income countries. We review the use of computer simulation modelling for the management of type 2 diabetes in low-and-middle-income countries. Methods A search for studies reporting computer simulation models of the natural history of individuals with type 2 diabetes and/or decision models to evaluate the impact of treatment strategies on these populations was conducted in PubMed. Data were extracted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and assessed using modelling checklists. Publications before the year 2000, from high-income countries, studies involving animals and analyses that did not use mathematical simulations were excluded. The full text of eligible articles was sourced and information about the intervention and population being modelled, type of modelling approach and the model structure was extracted. Results Of the 79 articles suitable for full text review, 44 studies met the inclusion criteria. All were cost-effectiveness/utility studies with the majority being from the East Asia and Pacific region (n = 29). Of the included studies, 34 (77.3%) evaluated the cost-effectiveness of pharmacological interventions and approximately 75% of all included studies used HbA1c as one of the treatment effects of the intervention. 32 (73%) of the publications were microsimulation models, and 29 (66%) were state-transition models. Most of the studies utilised annual cycles (n = 29, 71%), and accounted for costs and outcomes over 20 years or more (n = 38, 86.4%). Conclusions While the use of simulation modelling in the management of type 2 diabetes has been steadily increasing in low-and-middle-income countries, there is an urgent need to invest in evaluating therapeutic and policy interventions related to type 2 diabetes in low-and-middle-income countries through simulation modelling, especially with local research data. Moreover, it is important to improve transparency and credibility in the reporting of input data underlying model-based economic analyses, and studies.

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“…However, the IQVIA CDM is a widely published and validated model that has been used to estimate long-term clinical outcomes in T2DM within many contexts and comparing different healthcare technologies. 29 On the other hand, it is important to consider that the perspective of this analysis was from a public health service and only considers direct medical costs for both interventions. Hence, this analysis does not include discounted indirect costs or additional benefits, and this may have had an effect of subestimation of the total costs and, therefore, a bias on the estimated ICER, which could be even better.…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of a self-management and comprehensive training intervention in patients with type 2 diabetes up to 5 years of diagnosis in a specialized hospital in Mexico City

Hernández-Jiménez

García-Ulloa

Anaya

et al. 2021

BMJ Open Diab Res Care

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IntroductionTo assess the cost-effectiveness of a multidisciplinary and comprehensive innovative diabetes care program (CAIPaDi) versus usual treatment in public health institutions.Research design and methodsUsing a cost-effectiveness analysis, we compared the CAIPaDi program versus usual treatment given in Mexican public health institutions. The analysis was based on the IQVIA Core Diabetes Model, a validated simulation model used to estimate long-term clinical outcomes. Data were prospectively obtained from the CAIPaDi program and from public databases and published papers. Health outcomes were expressed in terms of life-years gained and quality-adjusted life years (QALYs). Health and economic outcomes were estimated from a public perspective and discounted at 5% per year over a 20-year horizon. Costs are reported in US dollars (US$) of 2019. A probabilistic sensitivity analysis was performed using life-years gained and QALYs.ResultsThe CAIPaDi costs on average US$559 (95% CI: −$879 to −$239) less than the usual treatment (95% CI: −$879 to −$239) and produced a difference in mean life-years gained (0.48, 95% CI: 0.45 to 0.52) and mean QALYs (1.43, 95% CI: 1.40 to 1.46). The cost-effectiveness ratio resulted in a saving per life-year gained of −US$1155 (95% CI: −$1962 to −$460). Mean differences in QALYs resulted in a saving per QALY of −US$735 (95% CI: −$1193 to −$305). Probabilistic sensitivity analysis proved the results are robust on both life-years gained and QALYs.ConclusionsCAIPaDi has a better cost-effectiveness ratio than the usual therapy in Mexican public health institutions.

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Economic Simulation Modeling in Type 2 Diabetes

Cited by 8 publications

References 49 publications

Modeling Chronic Kidney Disease in Type 2 Diabetes Mellitus: A Systematic Literature Review of Models, Data Sources, and Derivation Cohorts

Modeling Chronic Kidney Disease in Type 2 Diabetes Mellitus: A Systematic Literature Review of Models, Data Sources, and Derivation Cohorts

A review of simulation models for the long-term management of type 2 diabetes in low-and-middle income countries

Cost-effectiveness of a self-management and comprehensive training intervention in patients with type 2 diabetes up to 5 years of diagnosis in a specialized hospital in Mexico City

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