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[IP] The cost-effectiveness of continuous subcutaneous insulin infusion



I'm not sure why this link doesn't work...but here's the text of the abstract

 <A
HREF="http://www.blackwell-synergy.com/links/doi/10.1046/j.1464-5491.2003.009
91.x/abs/">Blackwell Synergy - Diabet Med, Vol 20, Issue 7, pp. 586-593: The
cost-effectiveness of continuous subcutaneous insulin infus..</A>

Diabetic Medicine
Volume 20 Issue 7 Page 586  - July 2003
doi:10.1046/j.1464-5491.2003.00991.x
 
    The cost-effectiveness of continuous subcutaneous insulin infusion
compared with multiple daily injections for the management of diabetes
P. Scuffham and L. Carr

 Abstract
Aims To estimate the cost effectiveness of continuous subcutaneous insulin
infusion (CSII) compared with multiple daily injections (MDI) for patients
using
insulin pumps.Methods We constructed a Markov model to estimate the costs and
outcomes for patients with insulin-dependent diabetes (IDDM) treated with
CSII using an insulin pump compared with MDI. Key parameters were obtained
from
the published scientific literature. The primary outcome was quality-adjusted
life years (QALYs). Monte Carlo simulations were undertaken for 10 000
hypothetical patients over 8 years of monthly cycles (the expected life of a
pump).
Results Over an 8-year period an average patient could expect to gain 0.48
[standard deviation (sd) 0.20] QALYs using CSII compared with MDI. The
additional
cost over 8 years for this gain was #5462 (sd#897). The incremental cost per
QALY was #11 461 (sd#3656). CSII was most cost-effective in patients who had
more
than two severe hypoglycaemic events per year and who required admission to
hospital at least once every year. Cases where CSII might be not economically
viable are cases where diabetes is well controlled with few severe
hypoglycaemic events. Results were most sensitive to the number of
hypoglycaemic events
per patient and the utility weights used to estimate QALYs.Conclusion CSII is
a
worthwhile investment when targeted to those who might benefit most.Diabet.
Med. 20, 586-593 (2003)
 
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