Cost-Effectiveness of Surgically Induced Weight Loss for the Management of Type 2 Diabetes: Modeled Lifetime Analysis
Cost-Effectiveness of Surgically Induced Weight Loss for the Management of Type 2 Diabetes: Modeled Lifetime Analysis
复制标题
DOI：
10.2337/dc08-1749
复制
发表时间：
2009-04-01
期刊：
影响因子：
16.2
通讯作者：
O'Brien, Paul E.
中科院分区：
文献类型：
--
作者：
Keating, Catherine L.;Dixon, John B.;O'Brien, Paul E.
目的-估计成本效益的手术引起的体重减轻相对于常规治疗的管理最近诊断为2型糖尿病的I/II类肥胖patients.RESEARCH设计和方法-本研究建立在一个试验内的成本效益分析。该分析比较了两个干预组之间的终身成本和质量调整生命年（QHLS）。干预成本是根据试验期间观察到的石油资源利用情况外推的。每个干预组中2年时糖尿病缓解的患者比例与试验中观察到的相同，2型糖尿病患者的医疗保健费用和获得QOL估计值所需的结局变量均来源于已发表文献。采用了保健系统的观点。成本和结果每年以3%贴现。费用以2006年澳元（AUD）（货币兑换：1 AUD = 0.74 USD）表示。结果-手术治疗患者一生中糖尿病缓解的平均年数为11.4，常规治疗患者为2.1。在他们的余生中，手术和常规治疗的患者分别活了15.7和14.5个折扣的Qdos。平均贴现终身成本为每例手术治疗患者98，900 AUD，每例常规治疗患者101，400 AUD。相对于传统的治疗，手术引起的体重减轻与平均2,400澳元和1.2额外的QALOS每patient.CONCLUSIONS -手术引起的体重减轻是一个占主导地位的干预（既节省医疗费用，并产生健康效益）管理最近诊断的2型糖尿病在澳大利亚I/II类肥胖患者。
OBJECTIVE - To estimate the cost-effectiveness of surgically induced weight loss relative to conventional therapy for the management of recently diagnosed type 2 diabetes in class I/II obese patients.RESEARCH DESIGN AND METHODS - This study builds on a within-trial cost-efficacy analysis. The analysis compares the lifetime costs and quality-adjusted life-years (QALYs) between the two intervention groups. Intervention costs were extrapolated based oil observed resource utilization during the trial. The proportion of patients in each intervention group with remission of diabetes at 2 years was the same as that observed in the trial, Health care costs for patients with type 2 diabetes and outcome variables required to derive estimates of QALYs were sourced from published literature. A health care system perspective was adopted. Costs and outcomes were discounted annually at 3%. Costs are presented in 2006 Australian dollars (AUD) (currency exchange: 1 AUD = 0.74 USD).RESULTS - The mean number of years in diabetes remission over a lifetime was 11.4 for surgical therapy patients and 2.1 for conventional therapy patients. Over the remainder of their lifetime, surgical and conventional therapy patients lived 15.7 and 14.5 discounted QALYs, respectively. The mean discounted lifetime costs were 98,900 AUD per surgical therapy patient and 101,400 AUD per conventional therapy patient. Relative to conventional therapy, surgically induced weight loss was associated with a mean health care saving of 2,400 AUD and 1.2 additional QALYs per patient.CONCLUSIONS - Surgically induced weight loss is a dominant intervention (it both saves health care costs and generates health benefits) for managing recently diagnosed type 2 diabetes in class I/II obese patients in Australia.