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Cost-effectiveness analysis of intensive blood-glucose control with metformin in overweight patients with type II diabetes (UKPDS No. 51).

Abstract

AIMS/HYPOTHESIS

To estimate the economic efficiency of intensive blood-glucose control with metformin compared with conventional therapy primarily with diet in overweight patients with Type II (non-insulin-dependent) diabetes mellitus.

METHODS

Cost-effectiveness analysis based on patient level data from a randomised clinical controlled trial involving 753 overweight (> 120% ideal body weight) patients with newly diagnosed Type II diabetes conducted in 15 hospital-based clinics in England, Scotland and Northern Ireland as part of the UK Prospective Diabetes Study. Subjects were allocated at random to an intensive blood-glucose control policy with metformin (n = 342) or a conventional policy primarily with diet (n = 411). The analysis was based on the cost of health care resources associated with metformin and conventional therapy and the estimated effectiveness in terms of life expectancy gained from within-trial effects.

RESULTS

Intensive blood-glucose control with metformin produced a net saving of 258 Pounds per patient (1997 United Kingdom prices) over the trial period (median duration of 10.7 years) due to lower complication costs, and increased life expectancy by 0.4 years (costs and benefits discounted at 6%).

CONCLUSIONS/INTERPRETATION

As metformin is both cost-saving in the United Kingdom and extends life expectancy when used as first line pharmacological therapy in overweight Type II diabetic patients, its use should be attractive to clinicians and health care managers alike.

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  • Authors+Show Affiliations

    ,

    Health Economics Research Centre, Department of Public Health, University of Oxford, Institute of Health Sciences, Headington, Oxford OX3 7LF, UK.

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    Source

    Diabetologia 44:3 2001 Mar pg 298-304

    MeSH

    Adult
    Aged
    Antihypertensive Agents
    Blood Glucose
    Blood Glucose Self-Monitoring
    Body Mass Index
    Cost-Benefit Analysis
    Costs and Cost Analysis
    Cross-Sectional Studies
    Diabetes Mellitus
    Diabetes Mellitus, Type 2
    Diet, Diabetic
    England
    Humans
    Hypertension
    Hypoglycemic Agents
    Insulin
    Metformin
    Middle Aged
    Northern Ireland
    Obesity
    Patient Education as Topic
    Scotland
    United Kingdom

    Pub Type(s)

    Clinical Trial
    Journal Article
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    11317659

    Citation

    Clarke, P, et al. "Cost-effectiveness Analysis of Intensive Blood-glucose Control With Metformin in Overweight Patients With Type II Diabetes (UKPDS No. 51)." Diabetologia, vol. 44, no. 3, 2001, pp. 298-304.
    Clarke P, Gray A, Adler A, et al. Cost-effectiveness analysis of intensive blood-glucose control with metformin in overweight patients with type II diabetes (UKPDS No. 51). Diabetologia. 2001;44(3):298-304.
    Clarke, P., Gray, A., Adler, A., Stevens, R., Raikou, M., Cull, C., ... Holman, R. (2001). Cost-effectiveness analysis of intensive blood-glucose control with metformin in overweight patients with type II diabetes (UKPDS No. 51). Diabetologia, 44(3), pp. 298-304.
    Clarke P, et al. Cost-effectiveness Analysis of Intensive Blood-glucose Control With Metformin in Overweight Patients With Type II Diabetes (UKPDS No. 51). Diabetologia. 2001;44(3):298-304. PubMed PMID: 11317659.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Cost-effectiveness analysis of intensive blood-glucose control with metformin in overweight patients with type II diabetes (UKPDS No. 51). AU - Clarke,P, AU - Gray,A, AU - Adler,A, AU - Stevens,R, AU - Raikou,M, AU - Cull,C, AU - Stratton,I, AU - Holman,R, AU - ,, PY - 2001/4/25/pubmed PY - 2001/8/24/medline PY - 2001/4/25/entrez SP - 298 EP - 304 JF - Diabetologia JO - Diabetologia VL - 44 IS - 3 N2 - AIMS/HYPOTHESIS: To estimate the economic efficiency of intensive blood-glucose control with metformin compared with conventional therapy primarily with diet in overweight patients with Type II (non-insulin-dependent) diabetes mellitus. METHODS: Cost-effectiveness analysis based on patient level data from a randomised clinical controlled trial involving 753 overweight (> 120% ideal body weight) patients with newly diagnosed Type II diabetes conducted in 15 hospital-based clinics in England, Scotland and Northern Ireland as part of the UK Prospective Diabetes Study. Subjects were allocated at random to an intensive blood-glucose control policy with metformin (n = 342) or a conventional policy primarily with diet (n = 411). The analysis was based on the cost of health care resources associated with metformin and conventional therapy and the estimated effectiveness in terms of life expectancy gained from within-trial effects. RESULTS: Intensive blood-glucose control with metformin produced a net saving of 258 Pounds per patient (1997 United Kingdom prices) over the trial period (median duration of 10.7 years) due to lower complication costs, and increased life expectancy by 0.4 years (costs and benefits discounted at 6%). CONCLUSIONS/INTERPRETATION: As metformin is both cost-saving in the United Kingdom and extends life expectancy when used as first line pharmacological therapy in overweight Type II diabetic patients, its use should be attractive to clinicians and health care managers alike. SN - 0012-186X UR - https://www.unboundmedicine.com/medline/citation/11317659/Cost_effectiveness_analysis_of_intensive_blood_glucose_control_with_metformin_in_overweight_patients_with_type_II_diabetes__UKPDS_No__51__ L2 - https://dx.doi.org/10.1007/s001250051617 DB - PRIME DP - Unbound Medicine ER -