English, Article edition: Economic Model of First-Line Drug Strategies to Achieve Recommended Glycaemic Control in Newly Diagnosed Type 2 Diabetes Mellitus Joe W. Ramsdell; Seth N. Braunstein; Jennifer M. Stephens; ...

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Physical Description
  • article
Language
  • English

Edition details

Title
  • Economic Model of First-Line Drug Strategies to Achieve Recommended Glycaemic Control in Newly Diagnosed Type 2 Diabetes Mellitus
Author
  • Joe W. Ramsdell
  • Seth N. Braunstein
  • Jennifer M. Stephens
  • Christopher F. Bell
  • Marc F. Botteman
  • Scott T. Devine
Physical Description
  • article
Notes
  • Objective: To assess the short-term direct medical costs and effectiveness associated with achieving recommended glycaemic goals using commonly prescribed first-line oral antihyperglycaemic medications in type 2 diabetes mellitus. Materials and Methods: A literature-based, decision-tree model was developed to project the number of patients achieving glycosylated haemoglobin values of <7% on oral therapies and the associated costs over a 3-year timeframe. For each first-line strategy, patients could progress to combination therapy using two or more agents prior to the introduction of insulin. The overall cost of treatment included costs (2001/​2002 values; $US) of comprehensive medical care, laboratory tests, patient education, drug therapy, home glucose monitoring and adverse events. Results: At 3 years, the overall cost of treatment for the various first-line strategies was $US6106 for glipizide gastrointestinal therapeutic system, $US6727 for metformin immediate release, $US6826 for metformin extended release, $US7141 for glibenclamide (glyburide)/​metformin, $US7759 for rosiglitazone and $US9298 for repaglinide. Costs of comprehensive routine medical care ranged from approximately $US1538-2128 in year 1 and from approximately $US952-1543 in subsequent years, for controlled and uncontrolled patients, respectively. Adverse events represented <1%, and drug therapies represented approximately 50%, of the overall cost, respectively. Substantial cost differences between the strategies were seen within the first year. Regardless of first-line therapy, patients progressed quickly to combination therapies, with effectiveness among the agents being similar. Conclusions: Short-term costs required to provide comprehensive diabetes care and achieve glycemic goals can be substantial. The model suggests a sulphonylurea strategy may provide similar effectiveness with cost savings over other agents and should be considered when selecting an initial drug therapy in newly diagnosed patients with type 2 diabetes mellitus.
  • Antihyperglycaemics, Cost-effectiveness, Glibenclamide/​metformin, Glipizide, Metformin, Pharmacoeconomics, Repaglinide, Rosiglitazone, Type-2-diabetes-mellitus
  • RePEc:wkh:phecon:v:21:y:2003:i:11:p:819-837
Language
  • English
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