Cost-effectiveness analysis of lifestyle interventions for preventing kidney disease in patients with type 2 diabetes
Cost-effectiveness analysis of lifestyle interventions for preventing kidney disease in patients with type 2 diabetes
复制标题
生活方式干预预防2型糖尿病患者肾脏疾病的成本效益分析
DOI：
10.1007/s10157-023-02357-7
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发表时间：
2023
影响因子：
2.3
通讯作者：
Fukuda Takashi
中科院分区：
文献类型：
--
作者：
Suzuki Yuta;Hoshi Keika;Shiroiwa Takeru;Fukuda Takashi
背景对2型糖尿病患者进行生活方式干预有助于降低慢性肾脏疾病的发生率。生活方式干预预防2型糖尿病患者肾脏疾病的成本效益仍未确定。我们的目标是从日本医疗保健支付者的角度建立一个马尔可夫模型，重点关注2型糖尿病患者肾脏疾病的发展，并检验生活方式干预的成本-效果。方法为了建立模型，包括生活方式干预效果在内的参数来自于前瞻性试验的结果和以前发表的文献。根据生活方式干预组和糖尿病支持教育组的成本和质量调整生命年(QALY)的差异计算增量成本-效果比(ICER)。我们估计了终生成本和有效性，假设患者的寿命为100年。结果生活方式干预与糖尿病支持教育相比，每QALY的ICER为1,510,838日元(13,031美元)。成本-效果可接受性曲线显示，与糖尿病支持教育相比，生活方式干预在每获得5,000,000日元(43,084美元)的门槛处具有成本效益的概率为93.6%。结论使用新开发的马尔可夫模型，从日本医疗保健支付者的角度来看，生活方式干预预防糖尿病患者肾脏疾病比糖尿病支持教育更具成本效益。马尔可夫模型中的模型参数必须更新以适应日本的设置。
BackgroundLifestyle interventions in patients with type-2 diabetes contribute to reducing the incidence of chronic kidney disease. The cost-effectiveness of lifestyle interventions to prevent kidney disease in patients with type-2 diabetes remains undetermined. We aimed to develop a Markov model from a Japanese healthcare payer’s perspective focusing on the development of kidney disease in patients with type-2 diabetes and examine the cost-effectiveness of lifestyle interventions.MethodsTo develop the model, the parameters, including lifestyle intervention effect, were derived from results of the Look AHEAD trial and previously published literature. Incremental cost-effectiveness ratios (ICER) were calculated from the difference in cost and quality-adjusted life years (QALY) between lifestyle intervention and diabetes support education groups. We estimated lifetime costs and effectiveness assuming patient’s life span to be 100 years. Costs and effectiveness were discounted by 2% annually.ResultsICER for lifestyle intervention compared to diabetes support education was JPY 1,510,838 (USD 13,031) per QALY. Cost-effectiveness acceptability curve showed that the probability that lifestyle intervention is cost-effective at the threshold of JPY 5,000,000 (USD 43,084) per QALY gained, compared to diabetes support education, is 93.6%.ConclusionsUsing a newly-developed Markov model, we illustrated that lifestyle interventions for preventing kidney disease in patients with diabetes would be more cost-effective from a Japanese healthcare payer’s perspective compared to diabetes support education. The model parameters in the Markov model must be updated to adapt to the Japanese setting.
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影响因子：
44.5
作者：
Knowler, W. C.;Bahnson, J. L.;Bantle, J. P.;Bertoni, A. G.;Bray, G. A.;Chen, H.;Cheskin, L.;Clark, J. M.;Egan, C.;Evans, M.;Foreyt, J. P.;Glasser, S. P.;Greenway, F. L.;Gregg, E. W.;Hazuda, H. P.;Hill, J. O.;Horton, E. S.;Hubbard, V. S.;Jakicic, J. M.;Jeffery, R. W.;Johnson, K. C.;Kahn, S. E.;Kitabchi, A. E.;Korytkowski, M.;Krakoff, J.;Kure, A.;Lewis, C. E.;Maschak-Carey, B. J.;Michaels, S.;Montez, M. G.;Nathan, D. M.;Nyenwe, E.;Patricio, J.;Peters, A.;Pi-Sunyer, X.;Pownall, H.;Wadden, T. A.;Wagenknecht, L. E.;Williamson, D. F.;Wing, R. R.;Wyatt, H.;Yanovski, S. Z.
通讯作者：
Yanovski, S. Z.
影响因子：
24
作者：
Cohen, David J.;Reynolds, Matthew R.
通讯作者：
Reynolds, Matthew R.
伏格列波糖预防日本糖耐量受损患者 2 型糖尿病的成本效益分析
影响因子：
3.2
作者：
S. Ikeda;Makoto Kobayashi;N. Tajima
通讯作者：
N. Tajima
微量白蛋白尿在日本 2 型糖尿病患者中很常见
影响因子：
16.2
作者：
H. Yokoyama;K. Kawai;M. Kobayashi
通讯作者：
M. Kobayashi
影响因子：
--
作者：
Wing, Rena R.;Bahnson, Judy L.;Bray, George A.;Clark, Jeanne M.;Coday, Mace;Egan, Caitlin;Espeland, Mark A.;Foreyt, John P.;Gregg, Edward W.;Goldman, Valerie;Haffner, Steven M.;Hazuda, Helen;Hill, James O.;Horton, Edward S.;Hubbard, Van S.;Jakicic, John;Jeffery, Robert W.;Johnson, Karen C.;Kahn, Steven;Killean, Tina;Kitabchi, Abbas E.;Lewis, Cora E.;Manus, Cathy;Maschak-Carey, Barbara J.;Michaels, Sara;Montez, Maria;Montgomery, Brenda;Nathan, David M.;Patricio, Jennifer;Peters, Anne;Pi-Sunyer, Xavier;Pownall, Henry;Reboussin, David;Rejeski, Jack;Rubin, Richard;Safford, Monika;Skarphol, Tricia;Van Dorsten, Brent;Wadden, Thomas A.;Wagenknecht, Lynne;Wesche-Thobaben, Jacqueline;West, Delia S.;Williamson, Donald;Yanovski, Susan Z.
通讯作者：
Yanovski, Susan Z.