ECONOMIC EVALUATION OF DIABETES MANAGEMENT STRATEGIES: INSIGHTS FROM PATIENT GLUCOSE CONTROL TRAJECTORIESLITHUANIAN NATIONAL HEALTH INSURANCE FUND'S ADMINISTRATIVE DATA
Author(s)
Barbora Butkute, MA;
National Health Insurance Fund, Vilnius, Lithuania
National Health Insurance Fund, Vilnius, Lithuania
OBJECTIVES: Diabetes mellitus poses a significant and growing burden on global healthcare systems. This study economically evaluated diabetes management in Lithuania, focusing on the cost-effectiveness of sustained glucose control and the economic implications of improving versus deteriorating control trajectories.
METHODS: This retrospective cohort study utilized longitudinal administrative data from the Lithuanian National Health Insurance Fund (NHIF) Sveidra database for 142,830 patients in 2022, 147,196 in 2023, and 155,519 in 2024. Patients were categorized into "always good," "always poor," "improved," and "deteriorated" control groups based on their HbA1c results from 2022 and 2024. Healthcare costs were extracted directly from the database, representing average annual costs over three years for Incremental Cost-Effectiveness Ratio (ICER) calculations. Quality-Adjusted Life Years (QALYs) were estimated annually using a comprehensive utility model. Two ICERs were computed: comparing "always good" versus "always poor" control, and "improved" versus "deteriorated" trajectories, both over a three-year period.
RESULTS: Total annual healthcare expenditure for diabetes patients in Lithuania rose from €61,016,796 in 2022 to €88,578,907 in 2024. Patients with sustained good glucose control consistently incurred significantly lower average annual costs (e.g., €322 per patient in 2022) compared to those with persistently poor control (e.g., €783 per patient in 2022). For the "always good" versus "always poor" comparison, the ICER was -€13,828.23 per QALY gained, indicating sustained good control is a dominant strategy. Comparing "improved" versus "deteriorated" control trajectories, the ICER was €5,948.89 per QALY gained, highlighting that interventions improving control are highly cost-effective.
CONCLUSIONS: Sustained good glucose control is a dominant strategy in diabetes management, yielding substantial economic savings and enhanced health benefits. Furthermore, efforts to improve diabetes control in patients with worsening conditions are highly cost-effective. These findings underscore the critical importance of proactive, long-term diabetes management and timely interventions in Lithuania, supporting more efficient allocation of healthcare resources.
METHODS: This retrospective cohort study utilized longitudinal administrative data from the Lithuanian National Health Insurance Fund (NHIF) Sveidra database for 142,830 patients in 2022, 147,196 in 2023, and 155,519 in 2024. Patients were categorized into "always good," "always poor," "improved," and "deteriorated" control groups based on their HbA1c results from 2022 and 2024. Healthcare costs were extracted directly from the database, representing average annual costs over three years for Incremental Cost-Effectiveness Ratio (ICER) calculations. Quality-Adjusted Life Years (QALYs) were estimated annually using a comprehensive utility model. Two ICERs were computed: comparing "always good" versus "always poor" control, and "improved" versus "deteriorated" trajectories, both over a three-year period.
RESULTS: Total annual healthcare expenditure for diabetes patients in Lithuania rose from €61,016,796 in 2022 to €88,578,907 in 2024. Patients with sustained good glucose control consistently incurred significantly lower average annual costs (e.g., €322 per patient in 2022) compared to those with persistently poor control (e.g., €783 per patient in 2022). For the "always good" versus "always poor" comparison, the ICER was -€13,828.23 per QALY gained, indicating sustained good control is a dominant strategy. Comparing "improved" versus "deteriorated" control trajectories, the ICER was €5,948.89 per QALY gained, highlighting that interventions improving control are highly cost-effective.
CONCLUSIONS: Sustained good glucose control is a dominant strategy in diabetes management, yielding substantial economic savings and enhanced health benefits. Furthermore, efforts to improve diabetes control in patients with worsening conditions are highly cost-effective. These findings underscore the critical importance of proactive, long-term diabetes management and timely interventions in Lithuania, supporting more efficient allocation of healthcare resources.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE430
Topic
Economic Evaluation
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)