Cost-Effectiveness of the New 2018 American College of Physicians Glycemic Control Guidance Statements Among US Adults With Type 2 Diabetes

Feb 1, 2021, 00:00
10.1016/j.jval.2020.09.010
https://www.valueinhealthjournal.com/article/S1098-3015(20)34415-6/fulltext
Title : Cost-Effectiveness of the New 2018 American College of Physicians Glycemic Control Guidance Statements Among US Adults With Type 2 Diabetes
Citation : https://www.valueinhealthjournal.com/action/showCitFormats?pii=S1098-3015(20)34415-6&doi=10.1016/j.jval.2020.09.010
First page : 227
Section Title : ECONOMIC EVALUATION
Open access? : No
Section Order : 227

Objectives

This study aims to estimate the national impact and cost-effectiveness of the 2018 American College of Physicians (ACP) guidance statements compared to the status quo.

Methods

Survey data from the 2011-2016 National Health and Nutrition Examination were used to generate a national representative sample of individuals with diagnosed type 2 diabetes in the United States. Individuals with A1c and individuals with A1c >8.0% and a life expectancy of >10 years are recommended to intensify their A1c level to 7.0% to 8.0% (group 3). We used a Markov-based simulation model to evaluate the lifetime cost-effectiveness of following the ACP recommended A1c level.

Results

14.41 million (58.1%) persons with diagnosed type 2 diabetes would be affected by the new guidance statements. Treatment deintensification would lead to a saving of $363 600 per quality-adjusted life-year (QALY) lost for group 1 and a saving of $118 300 per QALY lost for group 2. Intensifying treatment for group 3 would lead to an additional cost of $44 600 per QALY gain. Nationally, the implementation of the guidance would add 3.2 million life-years and 1.1 million QALYs and reduce healthcare costs by $47.7 billion compared to the status quo.

Conclusions

Implementing the new ACP guidance statements would affect a large number of persons with type 2 diabetes nationally. The new guidance is cost-effective.

Categories :
  • Cardiovascular Disorders
  • Cost-comparison, Effectiveness, Utility, Benefit Analysis
  • Economic Evaluation
  • Health Service Delivery & Process of Care
  • Specific Diseases & Conditions
  • Treatment Patterns and Guidelines
Tags :
  • cost-effectiveness
  • diabetes
  • glycemic control
  • microsimulation
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