Cost-effectiveness analysis of intensive blood-glucose control with metformin in overweight patients with Type II diabetes (UKPDS no. 51)
Cost-effectiveness analysis of intensive blood-glucose control with metformin in overweight patients with Type II diabetes (UKPDS no. 51)
Aims/hypothesis. to estimate the economic efficiency of intensive blood-glucose control with metformin compared with conventional therapy primarily with diet in overweight patients with Type II (non-insulin-dependent) diabetes mellitus.
Methods: cost-effectiveness analysis based on patient level data from a randomised clinical controlled trial involving 753 overweight (> 120% ideal body weight) patients with newly diagnosed Type II diabetes conducted in 15 hospital-based clinics in England, Scotland and Northern Ireland as part of the UK Prospective Diabetes Study. Subjects were allocated at random to an intensive blood-glucose control policy with metformin (n = 342) or a conventional policy primarily with diet (n = 411). The analysis was based on the cost of health care resources associated with metformin and conventional therapy and the estimated effectiveness in terms of life expectancy gained from within-trial effects.
Results: intensive blood-glucose control with metformin produced a net saving of £258 per patient (1997 United Kingdom prices) over the trial period (median duration of 10.7 years) due to lower complication costs, and increased life expectancy by 0.4 years (costs and benefits discounted at 6%).
Conclusions/interpretation: as metformin is both cost-saving in the United Kingdom and extends life expectancy when used as first line pharmacological therapy in overweight Type II diabetic patients, its use should be attractive to clinicians and health care managers alike.
Cost saving, Cost-effectiveness analysis, Economic evaluation, Metformin, Overweight patient, Type II diabetes
298-304
Clarke, P.
dc86b03c-15b1-49a8-bb41-df6e27439b95
Gray, A.
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Adler, A.
d02dfdd6-ca6f-4cdc-91ab-8eb79ff94d7f
Stevens, R.
5889858f-123b-4d7a-9028-b0cdcf70f73e
Raikou, M.
9a7d69c6-5cba-4f47-8f54-06d7975aec0a
Cull, C.
ae95233f-ce25-4c32-a5b9-368419e07826
Stratton, I.
772f25b9-23c0-4240-a3f6-1e76b03b172f
Holman, R.
336fb2f7-edb5-4d65-a7b0-465111cbd047
March 2001
Clarke, P.
dc86b03c-15b1-49a8-bb41-df6e27439b95
Gray, A.
d7968270-d7e7-4662-bf7e-166461e0e8d3
Adler, A.
d02dfdd6-ca6f-4cdc-91ab-8eb79ff94d7f
Stevens, R.
5889858f-123b-4d7a-9028-b0cdcf70f73e
Raikou, M.
9a7d69c6-5cba-4f47-8f54-06d7975aec0a
Cull, C.
ae95233f-ce25-4c32-a5b9-368419e07826
Stratton, I.
772f25b9-23c0-4240-a3f6-1e76b03b172f
Holman, R.
336fb2f7-edb5-4d65-a7b0-465111cbd047
Clarke, P., Gray, A., Adler, A., Stevens, R., Raikou, M., Cull, C., Stratton, I. and Holman, R.
(2001)
Cost-effectiveness analysis of intensive blood-glucose control with metformin in overweight patients with Type II diabetes (UKPDS no. 51).
Diabetologia, 44 (3), .
(doi:10.1007/s001250051617).
Abstract
Aims/hypothesis. to estimate the economic efficiency of intensive blood-glucose control with metformin compared with conventional therapy primarily with diet in overweight patients with Type II (non-insulin-dependent) diabetes mellitus.
Methods: cost-effectiveness analysis based on patient level data from a randomised clinical controlled trial involving 753 overweight (> 120% ideal body weight) patients with newly diagnosed Type II diabetes conducted in 15 hospital-based clinics in England, Scotland and Northern Ireland as part of the UK Prospective Diabetes Study. Subjects were allocated at random to an intensive blood-glucose control policy with metformin (n = 342) or a conventional policy primarily with diet (n = 411). The analysis was based on the cost of health care resources associated with metformin and conventional therapy and the estimated effectiveness in terms of life expectancy gained from within-trial effects.
Results: intensive blood-glucose control with metformin produced a net saving of £258 per patient (1997 United Kingdom prices) over the trial period (median duration of 10.7 years) due to lower complication costs, and increased life expectancy by 0.4 years (costs and benefits discounted at 6%).
Conclusions/interpretation: as metformin is both cost-saving in the United Kingdom and extends life expectancy when used as first line pharmacological therapy in overweight Type II diabetic patients, its use should be attractive to clinicians and health care managers alike.
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Published date: March 2001
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Acknowledgements. The UK Prospective Diabetes Study (UKPDS) Group: Radcliffe Infirmary, Oxford; Royal Infirmary, Aberdeen; General Hospital, Birmingham; St George's Hospital and Hammersmith Hospital, London; City Hospital, Belfast; North Staffordshire Royal Infirmary, Stoke-on-Trent; Royal Victoria Hospital, Belfast; St Helier Hospital, Carshal-ton; Whittington Hospital, London; Norfolk & Norwich Hospital; Lister Hospital, Stevenage; Ipswich Hospital; Ninewells Hospital, Dundee; Northampton Hospital. The co-operation of the patients and many National Health Service (NHS) and non-NHS staff at the centres is much appreciated. The major grants for this study were from the UK Medical Research Council, British Diabetic Association, the UK Department of Health, the National Eye Institute and the National Institute of Digestive, Diabetes and Kidney Disease in the National Institutes of Health, USA, the British Heart Foundation, Novo-Nordisk, Bayer, Bristol Myers Squibb, Hoechst, Lilly, Lipha and Farmitalia Carlo Erba. Other funding companies and agencies, the supervising committees, and all participating staff are listed in an earlier paper [1]. R. Stevens was supported by Wellcome Trust fellowship no. 054470/Z/98/Z/DG/NOS/fh. We are grateful to D. Groleau for providing research assistance, A. Briggs and D. Matthews for advice and P. Bassett for his assistance in the preparation of this manuscript.
Keywords:
Cost saving, Cost-effectiveness analysis, Economic evaluation, Metformin, Overweight patient, Type II diabetes
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Local EPrints ID: 487109
URI: http://eprints.soton.ac.uk/id/eprint/487109
ISSN: 0012-186X
PURE UUID: 9925c09a-b42c-4ebb-b7ba-4cbe84c0f0b6
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Date deposited: 14 Feb 2024 17:35
Last modified: 18 Mar 2024 04:01
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Author:
P. Clarke
Author:
A. Gray
Author:
A. Adler
Author:
R. Stevens
Author:
M. Raikou
Author:
C. Cull
Author:
I. Stratton
Author:
R. Holman
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