How Consistent is the Relationship between Improved Glucose Control and Modelled Health Outcomes for People with Type 2 Diabetes Mellitus? a Systematic Review

Hua, Xinyang; Lung, Thomas; Palmer, Andrew J.; Liu, Si; Herman, William H.; Clarke, Philip

doi:10.1007/s40273-016-0466-0

Cited by 16 publications

(12 citation statements)

References 102 publications

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“…The clinical results used in this study agree in general with previous reports using a disposable insulin delivery device 24,25,26 to show these devices are associated with improved glycemic control. Cost-effectiveness results from this study are also in agreement with another study on the cost-effectiveness of CSII vs MDI in the Netherlands, 17 40 Results in terms of increased QALYs and life expectancy per percent decrease in HbA1c were higher when using the CORE model compared with results using other models. Nonetheless, a multivariate regression analysis including all models predicted a 0.37 increase in QALYs per percent decrease in HbA1c, which would correspond to a 0.26 QALY difference between treatments in the current study.…”

Section: Discussionsupporting

confidence: 88%

“…Results when comparing this model to the CORE model are supported by a recent systematic review of the relationship between improved glucose control and modelled health outcomes. 40 Results in terms of increased QALYs and life expectancy per percent decrease in HbA1c were higher when using the CORE model compared with results using other models. Nonetheless, a multivariate regression analysis including all models predicted a 0.37 increase in QALYs per percent decrease in HbA1c, which would correspond to a 0.26 QALY difference between treatments in the current study.…”

Section: Discussionmentioning

confidence: 82%

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Cost-effectiveness of Simple Insulin Infusion Devices Compared to Multiple Daily Injections in Uncontrolled Type 2 Diabetics in the United States Based on a Simulation Model

Wahlqvist¹,

Warner²,

Morlock³

2018

JHEOR

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Background: As type 2 diabetes (T2D) progresses, administering basal and bolus insulin through multiple daily injections (MDI) is often required to achieve target control, although many people fail to achieve target levels. Continuous subcutaneous insulin infusion (CSII) treatment with traditional pumps has proven effective in this population, but use remains limited in T2D due to CSII cost and complexity. A new class of simple insulin infusion devices have been developed which are simpler to use and less expensive. This paper assesses at what price one such simple insulin infusion device, PAQ® (Cequr SA, Switzerland), may be cost-effective compared to MDI in people with T2D not in glycemic control in the United States. Methods: Published equations were used in a simulation model to project long-term cost-effectiveness over 40 years, combined with data from the recent OpT2mise study, assuming similar efficacy of CSII and simple insulin infusion. Cost-effectiveness was pre-defined in relation to per capita gross domestic product (GDP), where incremental cost-effectiveness ratios below 1X the per capita GDP per quality-adjusted life year (QALY) gained were defined as “highly cost-effective” and below 3X GDP per capita as “cost-effective.” Results: Simple insulin infusion resulted in 0.17 QALYs gained per patient compared to MDI, along with lifetime cost-savings of USD 66 883 per person due to reduced insulin use and less complications. Analyses on price sensitivity of simple insulin infusion indicated that a device such as the PAQ is cost-effective compared with MDI up to price points of around USD 17 per day. Conclusions: For people with T2D not in glycemic control on MDI, simple insulin infusion devices such as PAQ have the potential to be highly cost-effective in the United States.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 82%

Cost-effectiveness of Simple Insulin Infusion Devices Compared to Multiple Daily Injections in Uncontrolled Type 2 Diabetics in the United States Based on a Simulation Model

Wahlqvist¹,

Warner²,

Morlock³

2018

JHEOR

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“…Greater transparency about the validity tests that have already been performed on a model can increase confidence in the accuracy of the model [44]. Greater transparency could also facilitate a meta-analytic approach to decision modelling, with meta-modelling representing a more robust source of evidence for decision making [45].…”

Section: Scope and Rigourmentioning

confidence: 99%

Transparency in Decision Modelling: What, Why, Who and How?

Sampson

Arnold²,

Bryan

et al. 2019

PharmacoEconomics

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Transparency in decision modelling is an evolving concept. Recently, discussion has moved from reporting standards to open source implementation of decision analytic models. However, in the debate about the supposed advantages and disadvantages of greater transparency, there is a lack of definition. The purpose of this article is not to present a case for or against transparency, but rather to provide a more nuanced understanding of what transparency means in the context of decision modelling and how it could be addressed. To this end, we review and summarise the discourse to date, drawing on our collective experience. We outline a taxonomy of the different manifestations of transparency, including reporting standards, reference models, collaboration, model registration, peer review, and open source modelling. Further, we map out the role and incentives for the various stakeholders, including industry, research organisations, publishers, and decision-makers. We outline the anticipated advantages and disadvantages of greater transparency with respect to each manifestation, as well as the perceived barriers and facilitators to greater transparency. These are considered with respect to the different stakeholders and with reference to issues including intellectual property, legality, standards, quality assurance, code integrity, health technology assessment processes, incentives, funding, software, access and deployment options, data protection, and stakeholder engagement. For each manifestation of transparency, we discuss the 'what', 'why', 'who', and 'how'. Specifically, their meaning, why the community might (or might not) wish to embrace them, whose engagement as stakeholders is required, and how relevant objectives might be realised. We identify current initiatives aimed to improve transparency to exemplify efforts in current practice and for the future. KEY POINTS FOR DECISION-MAKERS There is a variety of manifestations of transparency in decision modelling, ranging in the amount of information and accessibility of information that they tend to provide. There is a broad array of stakeholders who create, manage, influence, evaluate, use, or are otherwise affected by, decision models. Given the range of stakeholders and interests related to increased transparency of decision models, achieving the benefits while managing the risks requires careful consideration. Issues such as intellectual property, legal matters, funding, use, and sharing of software need to be addressed.

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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].…”

Section: Introductionunclassified

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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How Consistent is the Relationship between Improved Glucose Control and Modelled Health Outcomes for People with Type 2 Diabetes Mellitus? a Systematic Review

Cited by 16 publications

References 102 publications

Cost-effectiveness of Simple Insulin Infusion Devices Compared to Multiple Daily Injections in Uncontrolled Type 2 Diabetics in the United States Based on a Simulation Model

Cost-effectiveness of Simple Insulin Infusion Devices Compared to Multiple Daily Injections in Uncontrolled Type 2 Diabetics in the United States Based on a Simulation Model

Transparency in Decision Modelling: What, Why, Who and How?

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

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