Diabetes care involving pharmacists to prevent CHD: a win-win?

A pharmacist

Previous research has shown that pharmacist involvement in the management of type 2 diabetes can improve HbA1c as well as blood pressure and cholesterol. These models of care may be more costly to deliver, however, compared with conventional primary care. This economic evaluation looked at the cost-effectiveness of pharmacist management in preventing cardiovascular disease in [read the full story…]

Diabetes accounted for 8.9% of prescribing costs in NHS England in 2011/12

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The NHS Information Centre has released audit data for prescriptions for diabetes medications in England in the financial year 2011/12. Along with an executive summary and full text PDF of the report, the NHS has released the source data stratified by PCT and a data quality statement to assist interpretation. The prescribing data covers insulins, [read the full story…]

Ranibizumab may be cost-effective for diabetic macular oedema

Macular_oedema

Blindness is one of the most serious microvascular complications of diabetes.  The most common cause is diabetic macular oedema (DME).  Current treatment with lasers is often unsuccessful. The new injectable drug ranibizumab, which works by selectively inhibiting vascular enothelial growth factor A, has been seen in the RESTORE trial to improve visual acuity and quality [read the full story…]

Possible benefits of insulin pumps compared with multiple daily injections

Insulin Pump with sensor

An appraisal of a 2010 systematic review of continuous subcutaneous insulin infusion (CSII, or insulin pumps) has been published in DARE. Research question: In diabetes, does CSII as compared with multiple daily injections (MDI), improve the clinical or cost-effectiveness of care? The review included both adults and children with type 1 or type 2 diabetes.  [read the full story…]

More evidence needed on the cost-effectiveness of peer support in type 2 diabetes

Tug of war

A recently study looked at the cost-effectiveness of a peer support intervention in type 2 diabetes. Study question: In type 2 diabetes in primary care, are peer-support programmes cost effective? Quality of life outcomes were assessed in a randomised trial while long term costs were derived from analysis of the UKPDS model. The evidence: The [read the full story…]

Lifestyle changes aimed at preventing type 2 diabetes were cost-effective for improving quality of life.

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A recent follow-up of a randomised trial looked at the long-term costs of different ways of preventing type 2 diabetes in people with impaired glucose tolerance. Clinical question: In people with impaired glucose tolerance and fasting hyperglycaemia, are lifestyle interventions, as compared to metformin or usual care, cost-effective? This paper reports the costs and quality [read the full story…]

Treating all patients with type 2 diabetes with ACE inhibitors reduces health costs.

A colourful selection of pills

Renal disease is one of the most devastating and costly complications of diabetes.  A recent economic evaluation assessed whether routine use of ACE inhibitors in type 2 diabetes is cost-effective. Clinical question: In type 2 diabetes, are ACE inhibitors cost-effective for preventing renal disease? The study compared three strategies: treat all patients at the time [read the full story…]

Unclear evidence on the costs of improving glycemic control in type 2 diabetes.

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The Centre for Reviews and Dissemination (CRD) reports an economic evaluation of the impact of helping more patients to achieve their HbA1c target. Clinical question: In type 2 diabetes, what are the costs of improving glycemic control from a health service perspective? The evidence This economic evaluation was a decision model based on: effectiveness data [read the full story…]

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Treating mild gestational diabetes may be cost-effective.

Taking a blood test during pregnancy

An economic evaluation has recently been evaluated by the Centre for Reviews and Dissemination (CRD).  They concluded that treatment for mild gestational diabetes is effective at improving maternal and neonatal outcomes. Clinical question: In women with mild gestational diabetes, are the benefits of treatment with diet or insulin worth the cost? The analysis was undertaken [read the full story…]

Bariatric surgery may be cost-effective for obesity with type 2 diabetes

A gastric band

An economic evaluation reported by the Centre for Reviews and Dissemination concludes that bariatric surgery, whether gastric bypass or gastric band, is cost-effective in a US payor setting. Clinical question In severely obese people with type 2 diabetes, is bariatric surgery cost-effective compared with usual care? The evidence This is a critical appraisal of a [read the full story…]