The Centre for Reviews and Dissemination (CRD) reports an economic evaluation of the impact of helping more patients to achieve their HbA1c target.
In type 2 diabetes, what are the costs of improving glycemic control from a health service perspective?
This economic evaluation was a decision model based on:
- effectiveness data for “usual care” derived from medical records
- effectiveness data for “improved care” derived from a search of Pubmed
- cost data from health insurance claims.
The study authors reported that the incremental annual cost of improved care, compared with usual care, $1,128 per additional patient achieving their goal of HbA1c <7%. This was based on an annual care cost estimate of $503 for usual care and $830 for improved care.
Other analyses were reported for HbA1c targets of 8% and 9% respectively.
Users of this research are advised to consider
- The lack of a direct comparison in the source literature. In particular, the source of effectiveness data appears to be retrospective outcomes research.
- The narrow perspective of the analysis, which does not include individual or societal perspectives.
- The explicit advice from the CRD to view this evidence with caution, due to methodological limitations.
Read the full text of the critical appraisal by the CRD.
Original article: Nuckols TK, McGlynn EA. Cost implications to health care payers of improving glucose management among adults with type 2 diabetes. Health Serv Res. 2011 Aug;46(4):1158-79.