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Wednesday, April 25, 2012
Abay Poster Exhibition and Hall (Millennium Hall)
Introduction: Diabetes and coronary heart disease (CHD) are mutually increasing at an epidemic rate and cost of uncontrolled and complicated diabetic CHD patients are increasing at the same rate. Objectives: The study aimed to estimate and compare the cost of conventional versus intensive blood glucose control, incremental cost-effectiveness and incremental cost per event-free year gained in patients with type 2 diabetes (T2DM). Methods: Thirty diabetic patients with cardiopathy attending the Cardiology Outdoor (OPD), BIRDEM were selected randomly and interviewed regarding the direct cost (cost of medical advice, investigations, medical and other treatment) and indirect cost [travel cost, cost of productivity loss, and cost of accompanying person(s)]. The comparison was between conventional (primarily diet) glucose control policy versus intensive control policy with a sulphonylurea or insulin Incremental cost-effectiveness analysis of T2DM (mean age 52 years). The incremental cost per event-free year gained within the trial period was paramounted. Results: The cost analysis in 30 patients showed that the total cost of treatment was US$ 13,308.16 with an average of US$ 443.60 per patient. On comparing the both groups, it was found that the cost difference was US$ 6657.74. The incremental cost of intensive management was $178 ($95 to $232) per patient and event-free time gained in the intensive group was 0.55 (0.18 to 0.92) years and the lifetime gain 1.19 (0.79 to 1.81) years. The incremental cost per event-free year gained was $356 (costs and effects discounted at 6% a year) and $198 (costs discounted at 6% a year and effects not discounted). Conclusions and Recommendations: Intensive blood glucose control in T2DM significantly increased treatment costs but substantially reduced the cost of complications and increased the time free of complications. Comprehensive care can reduce the burden of cardiopathy of diabetic patients even in a developing country.
Learning Objectives: Cost-effectiveness analysis of an intensive blood glucose control policy in patients with type 2 diabetes: Case study from a tertiary care hospital in Bangladesh Introduction: Diabetes and coronary heart disease (CHD) are mutually increasing at an epidemic rate and cost of uncontrolled and complicated diabetic CHD patients are increasing at the same rate. Objectives: The study aimed to estimate and compare the cost of conventional versus intensive blood glucose control, incremental cost-effectiveness and incremental cost per event-free year gained in patients with type 2 diabetes (T2DM). Methods: Thirty diabetic patients with cardiopathy attending the Cardiology Outdoor (OPD), BIRDEM were selected randomly and interviewed regarding the direct cost (cost of medical advice, investigations, medical and other treatment) and indirect cost [travel cost, cost of productivity loss, and cost of accompanying person(s)]. The comparison was between conventional (primarily diet) glucose control policy versus intensive control policy with a sulphonylurea or insulin Incremental cost-effectiveness analysis of T2DM (mean age 52 years). The incremental cost per event-free year gained within the trial period was paramounted. Results: The cost analysis in 30 patients showed that the total cost of treatment was US$ 13,308.16 with an average of US$ 443.60 per patient. On comparing the both groups, it was found that the cost difference was US$ 6657.74. The incremental cost of intensive management was $178 ($95 to $232) per patient and event-free time gained in the intensive group was 0.55 (0.18 to 0.92) years and the lifetime gain 1.19 (0.79 to 1.81) years. The incremental cost per event-free year gained was $356 (costs and effects discounted at 6% a year) and $198 (costs discounted at 6% a year and effects not discounted). Conclusions and Recommendations: Intensive blood glucose control in T2DM significantly increased treatment costs but substantially reduced the cost of complications and increased the time free of complications. Comprehensive care can reduce the burden of cardiopathy of diabetic patients even in a developing country.