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Cost-effectiveness analysis of a pharmacotherapeutic empowerment strategy for patients with type 2 diabetes mellitus
BACKGROUND: The economic feasibility of pharmacotherapeutic empowerment of patients with type 2 diabetes mellitus (DM2) is still not well established. OBJECTIVES: To evaluate the cost-effectiveness of an individual pharmacotherapeutic empowerment strategy (IPES) for patients with DM2. METHODS: This...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6673768/ https://www.ncbi.nlm.nih.gov/pubmed/31413839 http://dx.doi.org/10.1136/bmjdrc-2018-000647 |
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author | Gonçalves, Ana Carolina Oliveira Cazarim, Maurílio de Souza Sanches, Cristina Pereira, Leonardo Regis Leira Camargos, Ana Márcia Tomé Aquino, Jéssica Azevedo Oliveira Baldoni, Andre |
author_facet | Gonçalves, Ana Carolina Oliveira Cazarim, Maurílio de Souza Sanches, Cristina Pereira, Leonardo Regis Leira Camargos, Ana Márcia Tomé Aquino, Jéssica Azevedo Oliveira Baldoni, Andre |
author_sort | Gonçalves, Ana Carolina Oliveira |
collection | PubMed |
description | BACKGROUND: The economic feasibility of pharmacotherapeutic empowerment of patients with type 2 diabetes mellitus (DM2) is still not well established. OBJECTIVES: To evaluate the cost-effectiveness of an individual pharmacotherapeutic empowerment strategy (IPES) for patients with DM2. METHODS: This is a cost-effectiveness study nested in a non-randomized clinical trial with patients ≥18 years of age, of both genders, with low and moderate cardiovascular risks. This study was carried out from the perspective of the municipal health system of Divinópolis in Minas Gerais state, and compared patients submitted to an IPES and patients who received only traditional care, 1 year before the beginning of the intervention (baseline) and 1 year after its completion (follow-up). The costs of the services offered by the municipality were computed, and in the intervention group IPES costs were included. Glycated hemoglobin (A1c) was the effectiveness parameter adopted. Cost-effectiveness ratio analyses, incremental cost-effectiveness ratio (ICER), and sensitivity analysis were performed. RESULTS: In the analysis of cost-effectiveness, it is observed that a reduction of 0.359 in A1c costs US$708.47 in the intervention group and a reduction of 0.170 costs US$1927.13 in the control group. Thus, the ICER is US$387.66 per patient/year. In the sensitivity analysis, it was observed that the IPES was dominant in 19.8% of the simulated scenarios and cost-effective in 80.2%. CONCLUSIONS: The IPES is an alternative that presents economic feasibility for the municipal public health system scenario. The absence of randomization in patient selection is a limitation of this study. |
format | Online Article Text |
id | pubmed-6673768 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-66737682019-08-14 Cost-effectiveness analysis of a pharmacotherapeutic empowerment strategy for patients with type 2 diabetes mellitus Gonçalves, Ana Carolina Oliveira Cazarim, Maurílio de Souza Sanches, Cristina Pereira, Leonardo Regis Leira Camargos, Ana Márcia Tomé Aquino, Jéssica Azevedo Oliveira Baldoni, Andre BMJ Open Diabetes Res Care Clinical Care/Education/Nutrition BACKGROUND: The economic feasibility of pharmacotherapeutic empowerment of patients with type 2 diabetes mellitus (DM2) is still not well established. OBJECTIVES: To evaluate the cost-effectiveness of an individual pharmacotherapeutic empowerment strategy (IPES) for patients with DM2. METHODS: This is a cost-effectiveness study nested in a non-randomized clinical trial with patients ≥18 years of age, of both genders, with low and moderate cardiovascular risks. This study was carried out from the perspective of the municipal health system of Divinópolis in Minas Gerais state, and compared patients submitted to an IPES and patients who received only traditional care, 1 year before the beginning of the intervention (baseline) and 1 year after its completion (follow-up). The costs of the services offered by the municipality were computed, and in the intervention group IPES costs were included. Glycated hemoglobin (A1c) was the effectiveness parameter adopted. Cost-effectiveness ratio analyses, incremental cost-effectiveness ratio (ICER), and sensitivity analysis were performed. RESULTS: In the analysis of cost-effectiveness, it is observed that a reduction of 0.359 in A1c costs US$708.47 in the intervention group and a reduction of 0.170 costs US$1927.13 in the control group. Thus, the ICER is US$387.66 per patient/year. In the sensitivity analysis, it was observed that the IPES was dominant in 19.8% of the simulated scenarios and cost-effective in 80.2%. CONCLUSIONS: The IPES is an alternative that presents economic feasibility for the municipal public health system scenario. The absence of randomization in patient selection is a limitation of this study. BMJ Publishing Group 2019-07-16 /pmc/articles/PMC6673768/ /pubmed/31413839 http://dx.doi.org/10.1136/bmjdrc-2018-000647 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Clinical Care/Education/Nutrition Gonçalves, Ana Carolina Oliveira Cazarim, Maurílio de Souza Sanches, Cristina Pereira, Leonardo Regis Leira Camargos, Ana Márcia Tomé Aquino, Jéssica Azevedo Oliveira Baldoni, Andre Cost-effectiveness analysis of a pharmacotherapeutic empowerment strategy for patients with type 2 diabetes mellitus |
title | Cost-effectiveness analysis of a pharmacotherapeutic empowerment strategy for patients with type 2 diabetes mellitus |
title_full | Cost-effectiveness analysis of a pharmacotherapeutic empowerment strategy for patients with type 2 diabetes mellitus |
title_fullStr | Cost-effectiveness analysis of a pharmacotherapeutic empowerment strategy for patients with type 2 diabetes mellitus |
title_full_unstemmed | Cost-effectiveness analysis of a pharmacotherapeutic empowerment strategy for patients with type 2 diabetes mellitus |
title_short | Cost-effectiveness analysis of a pharmacotherapeutic empowerment strategy for patients with type 2 diabetes mellitus |
title_sort | cost-effectiveness analysis of a pharmacotherapeutic empowerment strategy for patients with type 2 diabetes mellitus |
topic | Clinical Care/Education/Nutrition |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6673768/ https://www.ncbi.nlm.nih.gov/pubmed/31413839 http://dx.doi.org/10.1136/bmjdrc-2018-000647 |
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