Cost-effectiveness of rosiglitazone oral combination for the treatment of type 2 diabetes in Germany.

Full Abstract

AIMS/HYPOTHESIS:
To assess the cost-effectiveness of rosiglitazone in combination with other oral agents for the treatment of overweight and obese patients with type 2 diabetes in Germany.

METHODS:
The Diabetes Decision Analysis of Cost--type 2 model was adapted for clinical practice and healthcare financing rules in Germany. The model was calibrated using Cost of Diabetes in Europe Type 2 study data and national statistics. The perspective is that of the sickness funds, and includes all hospital inpatient, ambulatory, rehabilitation, and diabetes therapy, other medications, and sickness leave. The model simulates lifetime treatment histories and associated health outcomes and costs for age and sex-matched cohorts of 1000 overweight and obese patients. The measures of effectiveness used in the analysis were life-years and quality adjusted life-years (QALYs).

RESULTS:
The combination therapy of rosiglitazone with metformin or sulfonylurea produces better glycaemic control than conventional care of metformin with sulfonylurea and insulin in most patients, extends the viability of oral therapy before requiring insulin, and typically leads to lifetime cost increases across all treatment types. The improvements in glycaemic control lead to survival gains and reductions in morbidity, because of the reduced risk of developing or progressing to later stages of complications. Improvements in morbidity and mortality generate additional QALYs. Costs and health outcomes combine to yield favourable incremental cost-effectiveness ratios, which fall below international 'willingness-to-pay' thresholds in the medium term.

CONCLUSION:
The model predicts that rosiglitazone in combination with other oral agents is a cost-effective intervention for the treatment of normal weight, overweight and obese patients with type 2 diabetes when compared with conventional care in Germany.

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Author information

Author/s: Shearer, Arran T (AT); Bagust, Adrian (A); Liebl, Andreas (A); Schoeffski, Oliver (O); Goertz, Anita (A);

Affiliation: York Health Economics Consortium, University of York, Heslington, UK. as57(-atsign-)york.ac.uk

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't; Review

Journal: PharmacoEconomics (Pharmacoeconomics), published in New Zealand. (Language: eng)

Reference: 2006-; vol 24 Suppl 1 (issue ) : pp 35-48

Dates: Created 2006/06/27; Completed 2006/07/20; Revised 2006/11/15;

PMID: 16800161, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentIn: Pharmacoeconomics. 2006;24(9):927-9; author reply 929-35. (PMID: 16942126)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Administration, Oral
Adult
Aged
Cost-Benefit Analysis
Diabetes Complications
Diabetes Mellitus, Type 2 - drug therapy; economics; rehabilitation
Drug Therapy, Combination
Economics, Pharmaceutical
Female
Germany
Hemoglobin A, Glycosylated - drug effects

Hospitalization - economics
Humans
Hypoglycemic Agents - administration & dosage; economics; therapeutic use
Insulin - economics; therapeutic use
Male
Metformin - administration & dosage; therapeutic use
Middle Aged
Models, Economic
Obesity - complications
Quality-Adjusted Life Years
Thiazolidinediones - administration & dosage; economics; therapeutic use

Associated Chemicals: Hemoglobin A, Glycosylated (0) ; Hypoglycemic Agents (0) ; Thiazolidinediones (0) ; Insulin (11061-68-0) ; rosiglitazone (122320-73-4) ; Metformin (657-24-9)

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