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Cost-effectiveness of a self-management and comprehensive training intervention in patients with type 2 diabetes up to 5 years of diagnosis in a specialized hospital in Mexico City

Sergio Hernández-Jiménez, Ana Cristina García-Ulloa, Pablo Anaya, Ricardo Gasca-Pineda, Luis Arturo Sánchez-Trujillo, Héctor Peña Baca, Eduardo González-Pier, Enrique O Graue-Hernández, Carlos Alberto Aguilar-Salinas, Franciso Javier Gómez-Pérez, David Kershenobich-Stalnikowitz
2021 BMJ Open Diabetes Research & Care  

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IntroductionTo assess the cost-effectiveness of a multidisciplinary and comprehensive innovative diabetes care program (CAIPaDi) versus usual treatment in public health institutions.Research design and methodsUsing a cost-effectiveness analysis, we compared the CAIPaDi program versus usual treatment given in Mexican public health institutions. The analysis was based on the IQVIA Core Diabetes Model, a validated simulation model used to estimate long-term clinical outcomes. Data were
more » ... y obtained from the CAIPaDi program and from public databases and published papers. Health outcomes were expressed in terms of life-years gained and quality-adjusted life years (QALYs). Health and economic outcomes were estimated from a public perspective and discounted at 5% per year over a 20-year horizon. Costs are reported in US dollars (US$) of 2019. A probabilistic sensitivity analysis was performed using life-years gained and QALYs.ResultsThe CAIPaDi costs on average US$559 (95% CI: −$879 to −$239) less than the usual treatment (95% CI: −$879 to −$239) and produced a difference in mean life-years gained (0.48, 95% CI: 0.45 to 0.52) and mean QALYs (1.43, 95% CI: 1.40 to 1.46). The cost-effectiveness ratio resulted in a saving per life-year gained of −US$1155 (95% CI: −$1962 to −$460). Mean differences in QALYs resulted in a saving per QALY of −US$735 (95% CI: −$1193 to −$305). Probabilistic sensitivity analysis proved the results are robust on both life-years gained and QALYs.ConclusionsCAIPaDi has a better cost-effectiveness ratio than the usual therapy in Mexican public health institutions.
doi:10.1136/bmjdrc-2020-002097 pmid:34167953 fatcat:prfbhdvczjhzvolxwiomrmxjoq
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Sergio Hernández-Jiménez, Ana Cristina García-Ulloa, Pablo Anaya, Ricardo Gasca-Pineda, Luis Arturo Sánchez-Trujillo, Héctor Peña Baca, Eduardo González-Pier, Enrique O Graue-Hernández, Carlos Alberto Aguilar-Salinas, Franciso Javier Gómez-Pérez, David Kershenobich-Stalnikowitz. "Cost-effectiveness of a self-management and comprehensive training intervention in patients with type 2 diabetes up to 5 years of diagnosis in a specialized hospital in Mexico City." BMJ Open Diabetes Research & Care 9.1 (2021) e002097