eCite Digital Repository

Treating diabetes to accepted standards of care: a 10-year projection of the estimated economic and health impact in patients with type 1 and type 2 diabetes mellitus in the United States

Citation

Minshall, ME and Roze, S and Palmer, AJ and Valentine, WJ and Foos, V and Ray, J and Graham, C, Treating diabetes to accepted standards of care: a 10-year projection of the estimated economic and health impact in patients with type 1 and type 2 diabetes mellitus in the United States, Clinical Therapeutics: The International, Peer-Reviewed Journal of Drug Therapy, 27, (6) pp. 940-950. ISSN 0149-2918 (2005) [Refereed Article]

DOI: doi:10.1016/j.clinthera.2005.06.006

Abstract

Objective: The aim of this study was to investigate the health-economic impact of maintaining glycosylated hemoglobin (HbA 1c.) values in all US patients with currently uncontrolled type 1 or type 2 diabetes mellitus at the American Diabetes Association (ADA) standard of 7.0% and the American Association of Clinical Endocrinologists(AACE) target of 6.5% compared with maintenance at current population-based values. Methods: The CORE-Center for Outcomes Research Diabetes Model was used to predict costs and outcomes for patients with uncontrolled type 1 and type 2 diabetes who remain at established population mean HbA lc values in comparison with those for patients who maintain the standard value of 7.0% or the target value of 6.5%. The analysis was run from a societal perspective over a 10-year time horizon. The costs of treating complications and medication costs were retrieved from published sources. Costs and clinical outcomes were discounted at 3% per annum. Sensitivity analyses were performed on the discount rate and time horizon. Results: This analysis found that maintaining HbA 1c at the ADA standard value of 7.0% and the AACE target value of 6.5% in patients with uncontrolled type 1 and type 2 diabetes could achieve total direct medical cost savings of nearly $35 and $50 billion, respectively, over 10 years. When indirect cost savings were included, the total savings increased to between nearly $50 billion and $72 billion for these respective HbA 1c targets, corresponding to 4% and 6% of the total annual US health care costs of $1.3 trillion. Reduced savings were observed with a higher discount rate and shorter time horizon, but savings increased as the time horizon became longer. These cost savings must be weighed against the cost of reaching the HbA 1c. goals and the likelihood of achieving the clinical objectives. Conclusions: Efficient targeting of financial resources toward the goal of lowering HbA 1c in line with published guidelines could lead to financial savings in the range from nearly $35 billion to $72 billion over the next 10 years. Copyright © 2005 Excerpta Medica, Inc.

Item Details

Item Type:Refereed Article
Research Division:Economics
Research Group:Applied Economics
Research Field:Health Economics
Objective Division:Health
Objective Group:Health and Support Services
Objective Field:Health Policy Economic Outcomes
Author:Palmer, AJ (Professor Andrew Palmer)
ID Code:74675
Year Published:2005
Web of Science® Times Cited:23
Deposited By:Research Division
Deposited On:2011-12-09
Last Modified:2011-12-13
Downloads:0

Repository Staff Only: item control page