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Cost effectiveness of an intensive blood glucose control policy in patients with type 2 diabetes: economic analysis alongside randomised controlled trial (UKPDS 41)

Cost effectiveness of an intensive blood glucose control policy in patients with type 2 diabetes: economic analysis alongside randomised controlled trial (UKPDS 41)
Cost effectiveness of an intensive blood glucose control policy in patients with type 2 diabetes: economic analysis alongside randomised controlled trial (UKPDS 41)

Objective: to estimate the cost effectiveness of conventional versus intensive blood glucose control in patients with type 2 diabetes. 

Design. incremental cost effectiveness analysis alongside randomised controlled trial. 

Setting: 23 UK hospital clinic based study centres. 

Participants: 3867 patients with newly diagnosed type 2 diabetes (mean age 53 years). 

Interventions: onventional (primarily diet) glucose control policy versus intensive control policy with a sulphonylurea or insulin. 

Main outcome measures: incremental cost per event-free year gained within the trial period. 

Results: intensive glucose control increased trial treatment costs by u695 (95% confidence interval u555 to u836) per patient but reduced the cost of complications by u957 (u233 to u1681) compared with conventional management. If standard practice visit patterns were assumed rather than trial conditions, the incremental cost of intensive management was u478 (-u275 to u1232) per patient. The within trial event-free time gained in the intensive group was 0.60 (0.12 to 1.10) years and the lifetime gain 1.14 (0.69 to 1.61) years. The incremental cost per event-free year gained was u1166 (costs and effects discounted at 6% a year) and u563 (costs discounted at 6% a year and effects not discounted). 

Conclusions: intensive blood glucose control in patients with type 2 diabetes significantly increased treatment costs but substantailly reduced the cost of complications and increased the time free of complications.

0959-8146
1373-1378
Gray, Alastair
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Raikou, Maria
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McGuire, Alistair
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Fenn, Paul
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Stevens, Richard
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Cull, Carole
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Stratton, Irene
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Adler, Amanda
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Holman, Rury
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Turner, Robert
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Gray, Alastair
3d36006e-b93b-459b-bf20-b413b4528a84
Raikou, Maria
9a7d69c6-5cba-4f47-8f54-06d7975aec0a
McGuire, Alistair
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Fenn, Paul
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Stevens, Richard
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Cull, Carole
ae95233f-ce25-4c32-a5b9-368419e07826
Stratton, Irene
772f25b9-23c0-4240-a3f6-1e76b03b172f
Adler, Amanda
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Holman, Rury
336fb2f7-edb5-4d65-a7b0-465111cbd047
Turner, Robert
66f04358-5363-4217-a885-00e12220c229

Gray, Alastair, Raikou, Maria, McGuire, Alistair, Fenn, Paul, Stevens, Richard, Cull, Carole, Stratton, Irene, Adler, Amanda, Holman, Rury and Turner, Robert (2000) Cost effectiveness of an intensive blood glucose control policy in patients with type 2 diabetes: economic analysis alongside randomised controlled trial (UKPDS 41). British medical journal, 320, 1373-1378. (doi:10.1136/bmj.320.7246.1373).

Record type: Article

Abstract

Objective: to estimate the cost effectiveness of conventional versus intensive blood glucose control in patients with type 2 diabetes. 

Design. incremental cost effectiveness analysis alongside randomised controlled trial. 

Setting: 23 UK hospital clinic based study centres. 

Participants: 3867 patients with newly diagnosed type 2 diabetes (mean age 53 years). 

Interventions: onventional (primarily diet) glucose control policy versus intensive control policy with a sulphonylurea or insulin. 

Main outcome measures: incremental cost per event-free year gained within the trial period. 

Results: intensive glucose control increased trial treatment costs by u695 (95% confidence interval u555 to u836) per patient but reduced the cost of complications by u957 (u233 to u1681) compared with conventional management. If standard practice visit patterns were assumed rather than trial conditions, the incremental cost of intensive management was u478 (-u275 to u1232) per patient. The within trial event-free time gained in the intensive group was 0.60 (0.12 to 1.10) years and the lifetime gain 1.14 (0.69 to 1.61) years. The incremental cost per event-free year gained was u1166 (costs and effects discounted at 6% a year) and u563 (costs discounted at 6% a year and effects not discounted). 

Conclusions: intensive blood glucose control in patients with type 2 diabetes significantly increased treatment costs but substantailly reduced the cost of complications and increased the time free of complications.

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Accepted/In Press date: 7 February 2000
Published date: 20 May 2000

Identifiers

Local EPrints ID: 487108
URI: http://eprints.soton.ac.uk/id/eprint/487108
ISSN: 0959-8146
PURE UUID: e5d6800b-8289-490f-b078-4aa2bd6cae1d
ORCID for Irene Stratton: ORCID iD orcid.org/0000-0003-1172-7865

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Date deposited: 14 Feb 2024 17:32
Last modified: 06 Jun 2024 02:10

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Contributors

Author: Alastair Gray
Author: Maria Raikou
Author: Alistair McGuire
Author: Paul Fenn
Author: Richard Stevens
Author: Carole Cull
Author: Irene Stratton ORCID iD
Author: Amanda Adler
Author: Rury Holman
Author: Robert Turner

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