[The Economic Evaluation of the GLICEMIA 2.0 Study as an Example of a Complex Intervention].

Autor: Forster C; dmac Medical Valley Digital Health Application Center GmbH, dmac Medical Valley Digital Health Application Center GmbH, Bamberg, Germany., Prax K; Department für Chemie und Pharmazie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany., Jaensch P; Forschungsinstitut IDC, Wilhelm Löhe Hochschule für angewandte Wissenschaften, Fürth, Germany., Müller S; Forschungsinstitut IDC, Wilhelm Löhe Hochschule für angewandte Wissenschaften, Fürth, Germany., Hepp T; Institut für Medizininformatik, Biometrie und Epidemiologie (IMBE), Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany., Schlager H; Wissenschaftliches Institut für Prävention im Gesundheitswesen der Bayerischen Landesapothekerkammer, München, Germany., Friedland K; Institut für Pharmazie und Biochemie, Johannes-Gutenberg-Universität Mainz, Mainz, Germany., Zerth J; Forschungsinstitut IDC, Wilhelm Löhe Hochschule für angewandte Wissenschaften, Fürth, Germany.; Professur für Management in Einrichtungen des Sozial- und Gesundheitswesens, Katholische Universität Eichstätt-Ingolstadt, Eichstatt, Germany.
Jazyk: němčina
Zdroj: Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)) [Gesundheitswesen] 2022 Dec; Vol. 84 (12), pp. 1165-1173. Date of Electronic Publication: 2022 Nov 08.
DOI: 10.1055/a-1924-7672
Abstrakt: Background: A piggyback approach was used to evaluate the cost-effectiveness of the prevention program delivered at the point of care pharmacy in the GLICEMIA 2.0 study that sought to guide participants in the intervention group to improved glycemic control in type 2 diabetes with sustained incentivization of lifestyle changes, therapeutic compliance, and adherence. The control group received passive medication management and monitoring.
Methods: Primary endpoint of the GLICEMIA 2.0 study was the stabilization of HbA1c values. For health economic evaluation, incremental differences in output changes were examined, defined as the difference in the distribution of the HbA1c values between both groups over time. Direct program costs and anticipated indirect costs of service utilization were used as cost parameters. A net monetary benefit approach was used to validate cost-effectiveness thresholds via the formation of ICER values.
Results: The intervention group had significantly higher reductions in HbA 1c -values. Risk stratification of initial HbA 1c showed (short-term) cost effectiveness for initially higher HbA1c values. Due to the limited study period, no long-term differences in medical resource utilization could be assessed.
Conclusion: The GLICEMIA program indicates considerable effectiveness potentials, especially for high-risk patients. The study design seems to have assisted the intervention group's adherence in contrast to the control group. Detailed impacts within the complex intervention could not be validated due to restrictions of the study design as a complex intervention. Overall, statements about effect sustainability and further utilization rates progressions are limited due to a lack of follow-up.
Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht.
(Thieme. All rights reserved.)
Databáze: MEDLINE
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