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Achieving Good Glycemic Control Early After Onset of Diabetes: A Cost-Effectiveness Analysis in Patients with Type 1 Diabetes in Sweden
Örebro University, School of Medical Sciences.ORCID iD: 0000-0003-1025-1682
Novo Nordisk Scandinavia AB, Malmö, Sweden.
Ossian Health Economics and Communications GmbH, Basel, Switzerland.
Ossian Health Economics and Communications GmbH, Basel, Switzerland.
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2018 (English)In: Diabetes Therapy, ISSN 1869-6953, E-ISSN 1869-6961, Vol. 9, no 1, p. 87-99Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Sweden has amongst the highest incidence rates of type 1 diabetes (T1D) in Europe. The high incidence and chronic nature of T1D result in high prevalence and economic burden. Improving glycemic control reduces the incidence of microvascular complications, which in turn reduces medical costs. The present study aimed to quantify the reductions in cost and improvements in quality-adjusted life expectancy with varying reductions in HbA1c in the T1D population.

METHODS: The IQVIA CORE Diabetes Model was used to simulate a typical Swedish population of patients with T1D experiencing HbA1c reductions from 0.1% to 0.8% (in 0.1% increments) from 7.9% at baseline. Analyses were conducted in simulated cohorts based on data from the Swedish National Diabetes Register (NDR) and in subgroups by sex, smoking status, and body mass index (BMI), with different sets of quality-of-life utilities included. Generalized least squares (GLS) models were used to test for significant differences between subgroups. Analyses were also performed to investigate the effect of the duration of HbA1c control. Analyses were run over 50 years and outcomes discounted at 3% per annum.

RESULTS: In the reference case analysis, reducing HbA1c lowered the incidence of microvascular and macrovascular complications and improved quality-adjusted life expectancy. GLS models identified a significantly larger benefit of reducing HbA1c in women over men, but found no significant differences in the magnitude of quality of life improvements with decreasing HbA1c when segregating by smoking status or BMI.

CONCLUSIONS: Reducing HbA1c in a population with T1D would reduce the incidence of microvascular complications, improve life expectancy and quality of life. Larger quality-of-life benefits were observed in younger and female adult patients, but no notable differences were observed in the benefits of glycemic control in smokers versus non-smokers or in patients with low or high BMI.

Place, publisher, year, edition, pages
Springer, 2018. Vol. 9, no 1, p. 87-99
Keywords [en]
Costs and cost analysis, Diabetes mellitus, type 1, Long-term complications, Quality of life, Sweden
National Category
Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:oru:diva-63303DOI: 10.1007/s13300-017-0344-6ISI: 000424293600008PubMedID: 29204855Scopus ID: 2-s2.0-85041517527OAI: oai:DiVA.org:oru-63303DiVA, id: diva2:1164251
Funder
Novo Nordisk
Note

Funding Agency:

Novo Nordisk Scandinavia AB, Malmö, Sweden

Available from: 2017-12-11 Created: 2017-12-11 Last updated: 2018-02-22Bibliographically approved

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Jendle, Johan

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