Table 6:
Summary of Published Cost-Effectiveness Analyses [28]
Study
and setting(s) |
Year of
Costs |
Methods |
Findings |
Sweden [32] |
2003 (SEK) |
Within trial
cost-effectiveness analysis of acarbose, based on STOP-NIDDM, 40 month time
horizon, projected total direct costs based on progression to T2DM or
cardiovascular disease. |
Acarbose dominant to placebo for high risk groups. |
Canada [33] |
2000 ($CD) |
Markov model based on DPP,
DPS and STOP-NIDDM, projected LE, diabetes-free years, and total direct
lifetime costs, 10 year time horizon. |
Acarbose and metformin dominant versus control, ILC cost-effective to control
(ICER $749 per life year gained) |
USA [11] |
2000 ($US) |
Within trial
cost-effectiveness of DPP interventions (3 years), direct and indirect costs,
extensive sensitivity analyses. |
ILC cost-effective versus
placebo. Significant improvements in economic benefits if implementation
costs reduced. |
USA [26] |
2000
($US) |
Markov model, DPP and
UKPDS data adapted to US setting, projected LE, QALE and total direct medical
costs, lifetime time horizon, healthcare payer and societal perspectives
taken. |
ILC dominant versus metformin,
metformin not cost-effective for over 65 years of age, outcomes sensitive to
the pricing of treatments. |
Australia, [34] France, Germany,
Switzerland, UK |
2002 (€) |
Markov model, based on
DPP, projected LE, years free of diabetes and total direct costs, lifetime
time horizon, extensive sensitivity analyses and sub-group analyses on age
and BMI. |
ILC and metformin dominant
versus control except UK (ICER €6,381 and 5,400 per life year gained,
respectively) |
Italy[35] |
2004 (€) |
Markov model, based on
DPP, adapted to italian setting, projected LE,years free of diabetes and
total direct costs,lifetime time horizon. |
ILC and metformin cost
effective vs control (ICER € 11,234 and 11,556 per life year
gained,respectively) |
Spain [36] |
2004 (€) |
Markov model, based on
DPP, adapted to Spanish setting, projected LE, years free of diabetes and
total direct costs, lifetime time horizon. |
Metformin cost-effective
versus control (ICER €5,080 per life year gained), IILC costs prohibitive due
to personnel costs. |
USA [37] |
2005 ($US) |
Archimedes model, based on
ILC intervention from DPP, projected LE, total direct costs, 30 year time
horizon. |
ICER $62,602 and $35,523
for ILC and metformin versus control, respectively. |