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Treating diabetes to accepted standards of care: a 10-year projection of the estimated economic and health impact in patients with type 1 and type 2 diabetes mellitus in the United States.
Clin Ther. 2005 Jun; 27(6):940-50.CT

Abstract

OBJECTIVE

The aim of this study was to investigate the health-economic impact of maintaining glycosylated hemoglobin (HbA(1c)) values in all US patients with currently uncontrolled type 1 or type 2 diabetes mellitus at the American Diabetes Association (ADA) standard of 7.0% and the American Association of Clinical Endocrinologists (AACE) target of 6.5% compared with maintenance at current population-based values.

METHODS

The CORE-Center for Outcomes Research Diabetes Model was used to predict costs and outcomes for patients with uncontrolled type 1 and type 2 diabetes who remain at established population mean HbA(1c) values in comparison with those for patients who maintain the standard value of 7.0% or the target value of 6.5%. The analysis was run from a societal perspective over a 10-year time horizon. The costs of treating complications and medication costs were retrieved from published sources. Costs and clinical outcomes were discounted at 3% per annum. Sensitivity analyses were performed on the discount rate and time horizon.

RESULTS

This analysis found that maintaining HbA(1c) at the ADA standard value of 7.0% and the AACE target value of 6.5% in patients with uncontrolled type 1 and type 2 diabetes could achieve total direct medical cost savings of nearly 35 US dollars and 50 billion US dollars , respectively, over 10 years. When indirect cost savings were included, the total savings increased to between nearly 50 billion US dollars and 72 billion US dollars for these respective HbA(1c) targets, corresponding to 4% and 6% of the total annual US health care costs of 1.3 trillion US dollars. Reduced savings were observed with a higher discount rate and shorter time horizon, but savings increased as the time horizon became longer. These cost savings must be weighed against the cost of reaching the HbA(1c) goals and the likelihood of achieving the clinical objectives.

CONCLUSIONS

Efficient targeting of financial resources toward the goal of lowering HbA(1c) in line with published guidelines could lead to financial savings in the range from nearly 35 billion US dollars to 72 billion US dollars over the next 10 years.

Authors+Show Affiliations

CORE-Center for Outcomes Research-USA, LLC, Fishers, IN 46038. minshall@thecenter.chNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16117994

Citation

Minshall, Michael E., et al. "Treating Diabetes to Accepted Standards of Care: a 10-year Projection of the Estimated Economic and Health Impact in Patients With Type 1 and Type 2 Diabetes Mellitus in the United States." Clinical Therapeutics, vol. 27, no. 6, 2005, pp. 940-50.
Minshall ME, Roze S, Palmer AJ, et al. Treating diabetes to accepted standards of care: a 10-year projection of the estimated economic and health impact in patients with type 1 and type 2 diabetes mellitus in the United States. Clin Ther. 2005;27(6):940-50.
Minshall, M. E., Roze, S., Palmer, A. J., Valentine, W. J., Foos, V., Ray, J., & Graham, C. (2005). Treating diabetes to accepted standards of care: a 10-year projection of the estimated economic and health impact in patients with type 1 and type 2 diabetes mellitus in the United States. Clinical Therapeutics, 27(6), 940-50.
Minshall ME, et al. Treating Diabetes to Accepted Standards of Care: a 10-year Projection of the Estimated Economic and Health Impact in Patients With Type 1 and Type 2 Diabetes Mellitus in the United States. Clin Ther. 2005;27(6):940-50. PubMed PMID: 16117994.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treating diabetes to accepted standards of care: a 10-year projection of the estimated economic and health impact in patients with type 1 and type 2 diabetes mellitus in the United States. AU - Minshall,Michael E, AU - Roze,Stéphane, AU - Palmer,Andrew J, AU - Valentine,William J, AU - Foos,Volker, AU - Ray,Joshua, AU - Graham,Claudia, PY - 2005/04/08/accepted PY - 2005/8/25/pubmed PY - 2006/6/1/medline PY - 2005/8/25/entrez SP - 940 EP - 50 JF - Clinical therapeutics JO - Clin Ther VL - 27 IS - 6 N2 - OBJECTIVE: The aim of this study was to investigate the health-economic impact of maintaining glycosylated hemoglobin (HbA(1c)) values in all US patients with currently uncontrolled type 1 or type 2 diabetes mellitus at the American Diabetes Association (ADA) standard of 7.0% and the American Association of Clinical Endocrinologists (AACE) target of 6.5% compared with maintenance at current population-based values. METHODS: The CORE-Center for Outcomes Research Diabetes Model was used to predict costs and outcomes for patients with uncontrolled type 1 and type 2 diabetes who remain at established population mean HbA(1c) values in comparison with those for patients who maintain the standard value of 7.0% or the target value of 6.5%. The analysis was run from a societal perspective over a 10-year time horizon. The costs of treating complications and medication costs were retrieved from published sources. Costs and clinical outcomes were discounted at 3% per annum. Sensitivity analyses were performed on the discount rate and time horizon. RESULTS: This analysis found that maintaining HbA(1c) at the ADA standard value of 7.0% and the AACE target value of 6.5% in patients with uncontrolled type 1 and type 2 diabetes could achieve total direct medical cost savings of nearly 35 US dollars and 50 billion US dollars , respectively, over 10 years. When indirect cost savings were included, the total savings increased to between nearly 50 billion US dollars and 72 billion US dollars for these respective HbA(1c) targets, corresponding to 4% and 6% of the total annual US health care costs of 1.3 trillion US dollars. Reduced savings were observed with a higher discount rate and shorter time horizon, but savings increased as the time horizon became longer. These cost savings must be weighed against the cost of reaching the HbA(1c) goals and the likelihood of achieving the clinical objectives. CONCLUSIONS: Efficient targeting of financial resources toward the goal of lowering HbA(1c) in line with published guidelines could lead to financial savings in the range from nearly 35 billion US dollars to 72 billion US dollars over the next 10 years. SN - 0149-2918 UR - https://www.unboundmedicine.com/medline/citation/16117994/Treating_diabetes_to_accepted_standards_of_care:_a_10_year_projection_of_the_estimated_economic_and_health_impact_in_patients_with_type_1_and_type_2_diabetes_mellitus_in_the_United_States_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0149-2918(05)00099-8 DB - PRIME DP - Unbound Medicine ER -