Cost-Effectiveness of the New 2018 American College of Physicians Glycemic Control Guidance Statements Among US Adults With Type 2 Diabetes
| Autor: | Hui Shao, Ann L. Albright, Ping Zhang, Michael Laxy, Edward W. Gregg |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty Status quo Cost effectiveness Cost-Benefit Analysis media_common.quotation_subject Control (management) Guidelines as Topic Glycemic Control Type 2 diabetes 03 medical and health sciences Life Expectancy 0302 clinical medicine Health care Humans Hypoglycemic Agents Medicine 030212 general & internal medicine Societies Medical Aged media_common Glycemic Glycated Hemoglobin business.industry 030503 health policy & services Health Policy Public Health Environmental and Occupational Health Middle Aged medicine.disease United States Models Economic Diabetes Mellitus Type 2 Family medicine Life expectancy Health Resources Survey data collection 0305 other medical science business |
| Zdroj: | Value in Health. 24:227-235 |
| ISSN: | 1098-3015 |
| Popis: | This study aims to estimate the national impact and cost-effectiveness of the 2018 American College of Physicians (ACP) guidance statements compared to the status quo.Survey data from the 2011-2016 National Health and Nutrition Examination were used to generate a national representative sample of individuals with diagnosed type 2 diabetes in the United States. Individuals with A1c6.5% on antidiabetic medications are recommended to deintensify their A1c level to 7.0% to 8.0% (group 1); individuals with A1c 6.5% to 8.0% and a life expectancy of10 years are recommended to deintensify their A1c level8.0% (group 2); and individuals with A1c8.0% and a life expectancy of10 years are recommended to intensify their A1c level to 7.0% to 8.0% (group 3). We used a Markov-based simulation model to evaluate the lifetime cost-effectiveness of following the ACP recommended A1c level.14.41 million (58.1%) persons with diagnosed type 2 diabetes would be affected by the new guidance statements. Treatment deintensification would lead to a saving of $363 600 per quality-adjusted life-year (QALY) lost for group 1 and a saving of $118 300 per QALY lost for group 2. Intensifying treatment for group 3 would lead to an additional cost of $44 600 per QALY gain. Nationally, the implementation of the guidance would add 3.2 million life-years and 1.1 million QALYs and reduce healthcare costs by $47.7 billion compared to the status quo.Implementing the new ACP guidance statements would affect a large number of persons with type 2 diabetes nationally. The new guidance is cost-effective. |
| Databáze: | OpenAIRE |
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