Comparison of medical resources and costs among patients with coronary heart disease and impaired glucose tolerance in the Acarbose Cardiovascular Evaluation trial.

Autor: Morrow LM; Health Economics Research Centre, University of Oxford, Oxford, UK., Becker F; Health Economics Research Centre, University of Oxford, Oxford, UK., Coleman RL; Diabetes Trials Unit, Radcliffe Department of Medicine, University of Oxford, Oxford, UK., Gerstein HC; Department of Medicine and Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Canada., Rydén L; Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden., Schöder S; Pharma Division, Bayer AG, Berlin, Germany., Gray AM; Health Economics Research Centre, University of Oxford, Oxford, UK., Leal J; Health Economics Research Centre, University of Oxford, Oxford, UK., Holman RR; Diabetes Trials Unit, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
Jazyk: angličtina
Zdroj: Journal of diabetes [J Diabetes] 2024 Feb; Vol. 16 (2), pp. e13473. Date of Electronic Publication: 2023 Nov 01.
DOI: 10.1111/1753-0407.13473
Abstrakt: Background: The Acarbose Cardiovascular Evaluation (ACE) trial (ISRCTN91899513) evaluated the alpha-glucosidase inhibitor acarbose, compared with placebo, in 6522 patients with coronary heart disease and impaired glucose tolerance in China and showed a reduced incidence of diabetes. We assessed the within-trial medical resource use and costs, and quality-adjusted life years (QALYs).
Methods: Resource use data were collected prospectively within the ACE trial. Hospitalizations, medications, and outpatient visits were valued using Chinese unit costs. Medication use was measured in drug days, with cardiovascular and diabetes drugs summed across the trial by participant. Health-related quality of life was captured using the EuroQol-5 Dimension-3 Level questionnaire. Regression analyses were used to compare resource use, costs, and QALYs, accounting for regional variation. Costs and QALYs were discounted at 3% yearly.
Results: Hospitalizations were 6% higher in the acarbose arm during the trial (rate ratio 1.06, p = .009), but there were no significant differences in total inpatient days (rate ratio 1.04, p = .30). Total costs per participant, including study drug, were significantly higher for acarbose (¥ [Yuan] 56 480, £6213), compared with placebo (¥48 079, £5289; mean ratio 1.18, p < 0.001). QALYs reported by participants in the acarbose arm (3.96 QALYs) were marginally higher than in the placebo arm (3.95 QALYs), but the difference was not statistically significant (0.01 QALYs; p = .58).
Conclusions: Acarbose, compared with placebo, participants cost more due to study drug costs and reported no statistically significant difference in QALYs. These higher within-trial costs could potentially be offset in future by savings from the acarbose-related lower incidence of diabetes.
(© 2023 The Authors. Journal of Diabetes published by Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje