Life prolonging of disease management programs in patients with type 2 diabetes is cost-effective

Drabik, Anna; Büscher, Guido; Sawicki, Peter T.; Thomas, K.; Gräf, Christian; Müller, Dirk; Stock, Stephanie

doi:10.1016/j.diabres.2011.09.015

Cited by 20 publications

(36 citation statements)

References 22 publications

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“…Since then a higher percentage of patients is enrolled in the DMP CAD, which might have changed the patient characteristics in the DMP over time. Whereas so far no economic analyses were conducted on health care expenditures for the DMP CAD in Germany, there are previous studies that focused on the DMPs COPD [35] and type 2 diabetes [13,[36][37][38][39][40]. In COPD, Achelrod et al [35] conducted a study using data of a statutory health insurance fund and found that expenditures for hospitalization, ambulatory care and medication were significantly higher in the DMP group, leading to significantly higher total health care expenditures.…”

Section: Comparison Of Findings With Literaturementioning

confidence: 99%

“…In COPD, Achelrod et al [35] conducted a study using data of a statutory health insurance fund and found that expenditures for hospitalization, ambulatory care and medication were significantly higher in the DMP group, leading to significantly higher total health care expenditures. Concerning type 2 diabetes, to date seven publications based on statutory health insurance claims data reported cost measures for the DMP type 2 diabetes [13,[36][37][38][39][40]. Five studies [13,36,38,39] reported overall health care expenditures-all of these studies reported lower costs in the DMP group, but only in two studies [36,38] the results were significant.…”

Section: Comparison Of Findings With Literaturementioning

confidence: 99%

“…In Germany, the first two DMPs (type 2 diabetes and breast cancer) were implemented nationwide in 2002, the DMP for coronary artery disease (CAD) followed as third on May 1, 2003 [12]. Today around 1.8 million people with chronic illness are enrolled in the DMP CAD [13]. Contrary to other countries, in which DMPs were implemented with a focus on scientific evidence, in Germany, DMP rollout was accompanied by an elaborate legal framework that involved quality-of-care requirements, a strict accreditation process, and strong financial incentives for statutory health insurance funds to set up programs [14].…”

Section: Introductionmentioning

confidence: 99%

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Patients with coronary artery disease after acute myocardial infarction: effects of continuous enrollment in a structured Disease Management Program on adherence to guideline-recommended medication, health care expenditures, and survival

et al. 2020

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Objective Acute myocardial infarction (AMI) carries increased risk of mortality and excess costs. Disease Management Programs (DMPs) providing guideline-recommended care for chronic diseases seem an intuitively appealing way to enhance health outcomes for patients with chronic conditions such as AMI. The aim of the study is to compare adherence to guidelinerecommended medication, health care expenditures and survival of patients enrolled and not enrolled in the German DMP for coronary artery disease (CAD) after an AMI from the perspective of a third-party payer over a follow-up period of 3 years. Methods The study is based on routinely collected data from a regional statutory health insurance fund (n = 15,360). A propensity score matching with caliper method was conducted. Afterwards guideline-recommended medication, health care expenditures, and survival between patients enrolled and not enrolled in the DMP were compared with generalized linear and Cox proportional hazard models. Results The propensity score matching resulted in 3870 pairs of AMI patients previously and continuously enrolled and not enrolled in the DMP. In the 3-year follow-up period the proportion of days covered rates for ACE-inhibitors (60.95% vs. 58.92%), anti-platelet agents (74.20% vs. 70.66%), statins (54.18% vs. 52.13%), and β-blockers (61.95% vs. 52.64%) were higher in the DMP group. Besides that, DMP participants induced lower health care expenditures per day (€58.24 vs. €72.72) and had a significantly lower risk of death (HR: 0.757). Conclusion Previous and continuous enrollment in the DMP CAD for patients after AMI is a promising strategy as it enhances guideline-recommended medication, reduces health care expenditures and the risk of death.

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Section: Comparison Of Findings With Literaturementioning

confidence: 99%

Section: Comparison Of Findings With Literaturementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Patients with coronary artery disease after acute myocardial infarction: effects of continuous enrollment in a structured Disease Management Program on adherence to guideline-recommended medication, health care expenditures, and survival

et al. 2020

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“…Total direct annual healthcare costs were between €3081.11 for employed patients (43) and €4882.11 for an average type 2 diabetes patient (42). Average annual healthcare costs during the rst three years in the disease management program diabetes mellitus type 2 for patients with antidiabetic medication were €3973.15 (€4274.27 for patients not participating) (53). A representative survey of the German population estimated €3482.73 annual healthcare costs of type 2 diabetes patients (56).…”

Section: Diabetes Costs In Germanymentioning

confidence: 99%

Costs and Its Drivers for Diabetes Mellitus Type 2 Patients in France and Germany: A Systematic Review of Economic Studies

Stegbauer¹,

Falivena

Moreno

et al. 2020

Preprint

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Background Type 2 diabetes represents an increasingly critical challenge for health policy worldwide. It absorbs massive resources for both patients and national economies to sustain direct and associated costs of treatment and indirect costs related to loss of work and wages. Last years are fuelling of innovations grounded on the remote control and personalised programs which are significantly improving the management of diabetes and the reduction of its related complications. In this view, this work attempts to update cost analysis reviews on type 2 diabetes, focusing on France and Germany, in order to explore most significant cost drivers and rooms for cost savings by technology advancement. Although characterized by different approaches in delivering care, France and Germany represent the primary European markets for diabetes technologies. Methods A systematic review of the literature was carried out in MEDLINE, Embase and EconLit for interventional, observational, and modelling studies on expenditures for type 2 diabetes management in France or Germany published since 2012. Included articles were analysed for annual direct, associated, and indirect costs of type 2 diabetes patients. An appraisal of study quality was performed. Results are summarised narratively. Results From 1.260 records, the final sample was composed of 24 papers selected according to predefined inclusion/exclusion criteria. Both France and Germany revealed a predominant focus on direct cost. Comparability was limited due to different study populations and cost categories used. Nevertheless, France seems to reimburse higher direct costs than Germany. Indirect costs were only available for Germany. According to prior literature, reported cost drivers are hospitalisation and prescriptions as well as higher HbA1c and BMI, treatment with insulin and complications all indicating the severity of the disease. Diversity in available data and in included costs limit the results and may explain differences found. Conclusions Preventing complications and glycaemic control are widely recognized as the most effective ways to govern the expenditure for the treatment of diabetes. The implementation of self-based supports, such as hybrid closed-loop metabolic, already implemented for type 1 diabetes management, are the key pillars for further debates and policymaking, involving the perspectives of both caregivers and patients.

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“…Broader testing and use of chronic disease management interventions in several countries have resulted in reports describing the challenges associated with such efforts, but very few have provided evidence of improved long-term health outcomes or reduced health care expenditures [12]–[22]. Positive reports that have been published have often come from non-experimental evaluations of clinic or practice-based interventions targeting a single chronic disease [21],[22]. Some researchers believe that innovations in nursing-led chronic disease management may help address chronic disease in areas of the world with less abundant health care resources, such as sub-Saharan Africa [23],[24].…”

Section: Introductionmentioning

confidence: 99%

Effect of a Community-Based Nursing Intervention on Mortality in Chronically Ill Older Adults: A Randomized Controlled Trial

Coburn¹,

Marcantonio²,

Lazansky³

et al. 2012

PLoS Med

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Life prolonging of disease management programs in patients with type 2 diabetes is cost-effective

Cited by 20 publications

References 22 publications

Patients with coronary artery disease after acute myocardial infarction: effects of continuous enrollment in a structured Disease Management Program on adherence to guideline-recommended medication, health care expenditures, and survival

Patients with coronary artery disease after acute myocardial infarction: effects of continuous enrollment in a structured Disease Management Program on adherence to guideline-recommended medication, health care expenditures, and survival

Costs and Its Drivers for Diabetes Mellitus Type 2 Patients in France and Germany: A Systematic Review of Economic Studies

Effect of a Community-Based Nursing Intervention on Mortality in Chronically Ill Older Adults: A Randomized Controlled Trial

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