Estimating the impact of better management of glycaemic control in adults with Type 1 and Type 2 diabetes on the number of clinical complications and the associated financial benefit

Abstract

Aim To estimate potential cost avoidance through modest and achievable improvements in glycaemic control in adults with Type 1 or Type 2 diabetes mellitus in the UK healthcare system. MethodsThe IMS Core Diabetes Model was used to examine the impact of improved glycaemic control (indicated by reduction in HbA 1c level), in a representative cohort of adults with Type 1 or Type 2 diabetes. The cumulative incidence of microvascular and macrovascular complications was modelled across 5-year periods to a 25-year time horizon. Complication costs were applied to the data to estimate potential accrued cost avoidance.Results Significant cost avoidance of~£340 m is apparent in the first 5 years, increasing to~£5.5bn after 25 years of sustained improvement in control. The overwhelming majority of cost avoidance arises from reductions in microvascular complications. In people with Type 1 diabetes the greatest cost avoidance comes from a reduction in renal disease (74% of cost avoidance), while in people with Type 2 diabetes it is generated by a reduction in foot ulcers, amputations and neuropathy: 57% cost avoidance). Greater cost reduction is accrued more rapidly in people with higher starting HbA 1c levels.Conclusion Modest improvements in glycaemic control generate significant reductions in the incidence and, therefore, cost of microvascular complications in people with Type 1 or Type 2 diabetes. This study provides clear support for the premise that prioritized and sustained investment in early and better intervention can provide concrete financial benefits in both the short and longer term. Diabet. Med. 33, 1575-1581 (2016

Cost of medication adherence and persistence in type 2 diabetes mellitus: a literature review

“…In addition, improvements in glycemic control have a positive economic impact. Using the CORE Diabetes Model, it was shown that modest and achievable improvements in glycemic control generate significant reductions in the incidence and cost of microvascular complications 3. A cost avoidance of £340 million was estimated after 5 years of sustained glycemic control, increasing to £5.5 billion after 25 years for the UK 3.…”

The Influence of Health Literacy and Depression on Diabetes Self-Management: A Cross-Sectional Study

“…It is reported to reduce the level of glycated haemoglobin level (HbA 1c ), a clinical measure of adequate control, by as much as 37% [8]. Having a lower HbA 1c value (≤7% or ≤53 mmol/mol) reduces the likelihood of developing micro- and macrovascular complications over time [9]. Despite the increasing evidence that supports the benefits of DSM, uptake remains low, especially in culturally diverse populations [10, 11].…”

Assessing the economic value of maintained improvements in Type 1 diabetes management, in terms of HbA1c, weight and hypoglycaemic event incidence

“…Recent studies have reported the health economic value of improved disease management in Type 2 diabetes 25, and estimated the potential costs avoided that a modest HbA 1c reduction would achieve within the UK healthcare system 7. In the present analysis, we quantified the health economic burden of inadequate Type 1 diabetes management in the UK, and estimated the value associated with incremental HbA 1c improvements, fewer hypoglycaemic events and reduced BMI in people with Type 1 diabetes.…”