Economic evaluation of the management for diabetes mellitus

1)建立了模拟糖尿病临床病程的系统模型。该系统模型包括500名虚构的患者(分别按性别和年龄)。此外，通过给定事件随机产生的条件，计算了总死亡率和糖尿病并发症引起的血管障碍死亡率相加的情况。使用系统模型计算的按性别和年龄段计算的生存概率与实际测量结果基本一致。因此，我们的模型具有很强的灵活性。2)糖尿病并发症发生的概率是暂时产生的，并且假定为并发症的独立系数和依赖系数。当独立性和这一从属等级在0-1之间计算时，视网膜病变和神经病变的独立和从属等级为0.61。对于各并发症的发生概率，由于用这种独立隶属程度代替了系统模型，使得模型更加准确。3)根据系统模型，糖尿病治疗的成本/收益比为0.30(男性和女性，各年龄段)，成本/QALYs为177万日元。40~44岁和QALY的预期寿命分别为：男性28.0(普通组36.1)，22.9；女性：33.3(普通组39.7)或25.2岁。

1)We developed the system model for carrying out the simulation of the diabetic clinical progress. 500 fictitious patients (according to a sex and age, respectively) were included in this system model. Furthermore, the case where general mortality rate and the mortality rate by the blood vessel obstacle by diabetic complications were added was calculated by having given the conditions which an event generates at random. The probability of survival according to a sex and age class as a result of the calculation using the system model was mostly in agreement with the actual measurement. Therefore, it became clear that our model has flexibility.2)The probability that diabetic complications are plurality creates expression temporarily, and is presumed with the coefficient of independence and dependence of complications. When independence and this subordinate grade were calculated in 0-1, the independent and subordinate grade of retinopathy and neuropathy was 0.61, for example. About the occurrence probability of each complication, since it substituted for the system model using this independent and subordinate extent, the model became more exact.3)According to the system model, the cost/benefit ratio of diabetes medical treatment was 0.30 (man and woman, all age), and the cost/QALYs was 1,770,000 yen. The life expectancy of 40-44 years old and QALYs were male: 28.0 (general group 36.1), 22.9, and female: 33.3 (general group 39.7) or 25.2 years.