OBJECTIVES

: To assess the impact on cardiovascular risk, life-years (LYs), quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratio (ICER) of three East Asian risk-prediction models (RPMs) and UKPDS82 using the IQVIA Core Diabetes Model v9.5.

METHODS

: Analyses were conducted for a Chinese cohort with recent type 2 diabetes (T2D) onset. A hypothetical treatment effect of -10% relative to baseline was simulated separately on the following parameters: HbA1c, systolic blood pressure (SBP), total or low-density lipoprotein cholesterol and body-mass index (BMI). A comparison of 10-year cumulative incidence (CI) of cardiovascular disease, LYs, QALYs and ICERs was undertaken for the following RPMs: UKPDS82, China-PAR (Yang, 2016), Korea (Park, 2015), and Japan (Yatsuya, 2016).

RESULTS

: The 10-year CI of stroke and myocardial infarction (MI) across the five RPM was: 7.1% and 2.4% (Chinese PAR), 11.8% and 4.0% (Korean RPM), 7.2% and 4.9% (Japanese RPM), 3.0% and 11.2% (UKPDS82). SBP was the main driver of cardiovascular benefit and LY gains in the Chinese and Korean RPMs whereas cholesterol TC was the main driver of LY gains with Japanese and UKPDS82. A -change in BMI was the main driver of QALYs gains across all RPMs. Despite the reversed stroke-to-MI ratio using East European RPMs there was only a small change in total LYs (0.03-0.09LY) and QALYs (0.02-0.07QALY) and hardly any change in incrementals (max 0.02QALY) applying the different treatments. Also, incremental costs did not change a lot (a few 100USD) and as such ICERs and conclusions did not change.

CONCLUSIONS

: An expected reversed stroke-to-MI ratio in East Asian populations compared with Western countries was shown, highlighting the importance of RPM selection. Nevertheless, the choice of risk equation hardly changed LYs and QALYs nor the ICERs, although the latter depend on the cost of an MI and a stroke.