Author(s)
Ostrowska J1, Jakubczyk M2, Niewada M3, Lipka I1, Petrova G4, Tcharaktchiev D4, Mitkova Z4, Tsonev S5, Verkauskiene R6, Popovic Pejicic S7, Vulic D7, Seranic A8, Pana A9, Vasile Ileanu B9, Došenovič Bonča P10, Janša K11, Valov V12, Jokubauskiene G13, Hałdaś M14, Jusufovic R15, Ciocirlan R16, Stariha J17, Russel-Szymczyk M14
1HealthQuest, Warsaw, Poland, 2SGH Warsaw School of Economics, Warsaw, Poland, 3Department of Experimental & Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland, 4Medical University of Sofia, Sofia, Bulgaria, 5Acibadem City Clinic, Sofia, Bulgaria, 6Department and Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania, 7Department of Internal Medicine, Faculty of Medicine University of Banja Luka, Banja Luka, Bosnia and Herzegovina, 8Ministry of Health and Social Welfare of the Republic of Srpska, Bosnia and Herzegovina, Banja Luka, Bosnia and Herzegovina, 9Center for Health and Outcome Evaluation, Bucharest University of Economic Studies, Bucharest, Romania, 10Faculty of Economics, University of Ljubljana, Ljubljana, Slovenia, 11General Hospital, Jesenice, Slovenia, 12Novo Nordisk Pharma EAD, Sofia, Bulgaria, 13Novo Nordisk Pharma UAB, Vilnius, Lithuania, 14Novo Nordisk Pharma Sp. z o.o., Warsaw, Poland, 15Novo Nordisk Pharma d.o.o., Sarajevo, Bosnia and Herzegovina, 16Novo Nordisk Pharma S.R.L., Bucharest, Romania, 17Novo Nordisk d.o.o., Ljubliana, Slovenia
OBJECTIVES: Cardiovascular complications (CVCs) in diabetes mellitus (DM) are important from clinical and economic perspective. Pragmatic search of literature demonstrated lack of cost data for Central and Eastern Europe (CEE), while the rapid health technology assessment (HTA) advancement requires substantiated information to guide decisions. We aimed to estimate the direct public payer medical costs of CVCs in Bulgaria, Lithuania, Poland, Republic of Srpska, Bosnia and Herzegovina (RSBH), Romania, and Slovenia. METHODS: The considered CVCs included: myocardial infarction (MI), unstable (UA)/stable angina pectoris, peripheral vascular disease (PVD), heart failure (HF), stroke, transient ischemic attack, painful neuropathy, retinopathy, end-stage renal disease (ESRD), and diabetic foot. Local clinical and HTA experts provided data (based on experience, literature, databases, etc.) on epidemiology, rate/prevalence of CVCs, mortality (at the event and during follow-up), and cost (event, 1st year, subsequent years; split into hospitalizations, other procedures, and drugs) by filling a unified questionnaire. All doubts and inconsistencies were discussed. RESULTS: The total cost (all costs expressed in Euros per annum) amounted to 1,231 million in Poland, 581 million in Romania, 103 million in Bulgaria, 76 million in Slovenia, 47 million in RSBH, and 26 million in Lithuania (hospitalizations only, resulting in possible underestimation). The cost per single DM patient was similar for Romania, Slovenia, Poland, and RSBH (range 586–759) and lower in Lithuania (267.6) and Bulgaria (218.5). The average (for all countries, except Lithuania) share of individual CVCs in total cost is largest for HF (20.9%), followed by around 13% for MI, UA, stroke, and ESRD. CONCLUSIONS: Our study is the first attempt to assess the cost of DM-related CVCs in CEE and can be used in economic modelling. CVCs form an important financial burden for public payers. Collecting data for several countries is challenging as available information differs, but it allows quality checks by juxtaposing the input parameters.
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PDB15
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies, Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Cardiovascular Disorders, Diabetes/Endocrine/Metabolic Disorders
