Self-monitoring of blood glucose (SMBG) in patients with type 2 diabetes on oral anti-diabetes drugs: cost-effectiveness in France, Germany, Italy, and Spain
Self-monitoring of blood glucose (SMBG) in patients with type 2 diabetes on oral anti-diabetes drugs: cost-effectiveness in France, Germany, Italy, and Spain
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DOI：
10.1185/03007990903429765
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发表时间：
2010-01-01
影响因子：
2.3
通讯作者：
Foos, Volker
中科院分区：
文献类型：
--
作者：
Tunis, Sandra L.;Willis, William D.;Foos, Volker
目的：欧洲的利益相关者仍然对评估口服抗糖尿病药物 (OAD) 治疗的 2 型糖尿病患者血糖自我监测 (SMBG) 的特定国家价值感兴趣。本研究使用 IMS-CORE 糖尿病模型，从法国、德国、意大利和西班牙国家报销系统的角度，预测了该人群每天一次、两次或三次 SMBG（与无 SMBG 相比）的长期（40 年）成本效益。方法：SMBG 投入成本（试纸、刺血针、仪表、护士培训）由 LifeScan 提供（原文如此）2007 年值，并酌情适用于每个国家的情况报销政策。队列特征和假设的 Hb(A1c) 效应来自美国 Kaiser Permanente 对新 SMBG 用户的纵向分析。使用了针对特定国家的筛查计划和几种伴随药物的使用以及死亡率的估计。截至（原文如此）2007 年，已公布来源的国家/地区特定并发症费用有所夸大。法国、德国和意大利的基本案例结果每年折扣 3%；西班牙为 6%。敏感性分析每个国家不同的时间范围和贴现率。他们还包括第一年 SMBG 的负效用为 -0.036。主要结果指标：主要结果包括总直接成本、质量调整生命年 (QALY) 的收益以及 40 年来的增量成本效益比 (ICER)。结果：ICER 最大的是法国（包括仪表成本）和意大利（条带/刺血针的报销成本最高）。在法国，SMBG 每天一次、两次和三次的 ICER 分别为（原文如此）12114、（原文如此）6282 和（原文如此）7958；意大利的（原文如此）12 694、（原文如此）11 934 和（原文如此）15 368。 SMBG 的 ICER 每天一次或两次
Objective: Stakeholders in Europe remain interested in assessments of country-specific value of self-monitoring of blood glucose (SMBG) for patients with type 2 diabetes treated with oral anti-diabetes drugs (OADs). This study used the IMS-CORE Diabetes Model to project the long-term (40-year) cost-effectiveness of SMBG at once, twice, or three times per day (vs. no SMBG) for this population from national reimbursement system perspectives in France, Germany, Italy, and Spain.Methods: SMBG input costs (strips, lancets, meters, nurse training) were supplied by LifeScan in (sic)2007 values and applied as appropriate for each country's reimbursement policy. Cohort characteristics and assumed Hb(A1c) effects came from a US Kaiser Permanente longitudinal analysis of new SMBG users. Country-specific estimations for use of screening programs and several concomitant medications, as well as mortality rates were used. Country-specific complication costs from published sources were inflated to (sic)2007. Base case outcomes were discounted at 3% per annum for France, Germany, and Italy; 6% for Spain. Sensitivity analyses varied time horizon and discount rates for each country. They also included a -0.036 dis-utility for SMBG in year 1.Main outcome measures: Primary outcomes included total direct costs, gains in quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs) over 40 years.Results: ICERs were largest in France (with meter costs included), and in Italy (with highest reimbursed costs for strips/lancets). ICERs for SMBG once, twice, and three times per day were (sic)12114, (sic)6282, and (sic)7958 (respectively) in France; and (sic)12 694, (sic)11 934, and (sic)15 368 in Italy. ICERs for SMBG once or twice per day were