Unknown

Dataset Information

0

Cost-effectiveness of the diabetes care protocol, a multifaceted computerized decision support diabetes management intervention that reduces cardiovascular risk.


ABSTRACT:

Objective

The Diabetes Care Protocol (DCP), a multifaceted computerized decision support diabetes management intervention, reduces cardiovascular risk of type 2 diabetic patients. We performed a cost-effectiveness analysis of DCP from a Dutch health care perspective.

Research design and methods

A cluster randomized trial provided data of DCP versus usual care. The 1-year follow-up patient data were extrapolated using a modified Dutch microsimulation diabetes model, computing individual lifetime health-related costs, and health effects. Incremental costs and effectiveness (quality-adjusted life-years [QALYs]) were estimated using multivariate generalized estimating equations to correct for practice-level clustering and confounding. Incremental cost-effectiveness ratios (ICERs) were calculated and cost-effectiveness acceptability curves were created. Stroke costs were calculated separately. Subgroup analyses examined patients with and without cardiovascular disease (CVD+ or CVD- patients, respectively).

Results

Excluding stroke, DCP patients lived longer (0.14 life-years, P = NS), experienced more QALYs (0.037, P = NS), and incurred higher total costs (euro 1,415, P = NS), resulting in an ICER of euro 38,243 per QALY gained. The likelihood of cost-effectiveness given a willingness-to-pay threshold of euro 20,000 per QALY gained is 30%. DCP had a more favorable effect on CVD+ patients (ICER = euro 14,814) than for CVD- patients (ICER = euro 121,285). Coronary heart disease costs were reduced (euro-587, P < 0.05).

Conclusions

DCP reduces cardiovascular risk, resulting in only a slight improvement in QALYs, lower CVD costs, but higher total costs, with a high cost-effectiveness ratio. Cost-effective care can be achieved by focusing on cardiovascular risk factors in type 2 diabetic patients with a history of CVD.

SUBMITTER: Cleveringa FG 

PROVIDER: S-EPMC2809259 | biostudies-literature | 2010 Feb

REPOSITORIES: biostudies-literature

altmetric image

Publications

Cost-effectiveness of the diabetes care protocol, a multifaceted computerized decision support diabetes management intervention that reduces cardiovascular risk.

Cleveringa Frits G W FG   Welsing Paco M J PM   van den Donk Maureen M   Gorter Kees J KJ   Niessen Louis W LW   Rutten Guy E H M GE   Redekop William K WK  

Diabetes care 20091123 2


<h4>Objective</h4>The Diabetes Care Protocol (DCP), a multifaceted computerized decision support diabetes management intervention, reduces cardiovascular risk of type 2 diabetic patients. We performed a cost-effectiveness analysis of DCP from a Dutch health care perspective.<h4>Research design and methods</h4>A cluster randomized trial provided data of DCP versus usual care. The 1-year follow-up patient data were extrapolated using a modified Dutch microsimulation diabetes model, computing indiv  ...[more]

Similar Datasets

| S-EPMC9440130 | biostudies-literature
| S-EPMC7220796 | biostudies-literature
| S-EPMC9034761 | biostudies-literature
| S-EPMC3459233 | biostudies-literature
| S-EPMC6558725 | biostudies-literature
| S-EPMC4822023 | biostudies-other
| S-EPMC5375083 | biostudies-literature
| S-EPMC4608282 | biostudies-literature
| S-EPMC2736031 | biostudies-literature
| S-EPMC9544153 | biostudies-literature