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Re: [IPk] Fw: Intensive Blood Glucose Control Is Cost-Effectivein Type 2 Diabetics

>>So not only does intensive treatment of Type 2 diabetes improve glycemic
>>control it also saves money !
>I guess you don't have to be a rocket scientist to figure that out.

Hmmm... but it needs proving.

Of course, from our point of view, "as cheap as possible" is not a
substitute for "as good as possible". And I happen to value my own good
health and quality of life extremely highly!

But being able to direct a budget-capped health manager to such a report
may be one route forward...


>WESTPORT, May 22 (Reuters Health) - Intensive blood glucose control in type
>2 diabetics costs more than conventional therapy, but provides savings in the
>form of reduced complications, according to a report in the May 20th issue of
>the British Medical Journal.
>Dr. Alastair Gray, of the University of Oxford, in Headington, UK, and
>colleagues used data from the 10-year United Kingdom Prospective Diabetes
>Study to evaluate the cost-effectiveness of intensive blood glucose control
>(maintaining fasting blood glucose below 6 mmol/L) compared with
>conventional control (maintaining fasting blood glucose below 15 mmol/L) in
>3,867 patients with newly diagnosed type 2 diabetes. The intensive blood
>glucose control patients received either insulin or sulfonylurea drugs.
>The average incremental cost of intensive anti-diabetic treatment, compared
>with conventional management, was 659 British pounds sterling, the authors
>report. In contrast, the mean cost of hospital admissions was higher for the
>conventional management group (4,266 pounds versus 3,494 pounds for the
>intensive control group), largely because of longer lengths of stay and
>higher numbers of admissions.
>The reduced cost of complications (hospitalizations) in the intensive control
>group counterbalanced the increased cost of treatment, the investigators note,
>resulting in insignificant differences in total costs between the two
>approaches. These comparisons held when insulin and sulfonylurea therapies
>were analyzed separately.
>Cost-effectiveness was evaluated using the incremental cost per year of
>event-free survival, the report indicates. Discounting the costs at 6% per
>and leaving the effects undiscounted, the authors arrive at a cost of 563
>pounds per event-free year gained.
>"With costs and effects discounted at 6% a year," they add, "there is a 10%
>probability that intensive blood glucose control policy would prove to be cost
>saving compared with a conventional policy, a 50% probability that the cost
>per event-free year lies above (or below) the point estimate of 1,166 pounds,
>and an 80% probability that the ratio is less than 2,500 pounds."
>"Our results suggest that intensive management of patients with type 2
>diabetes is a feasible and economically supportable option," the authors
>BMJ 2000;320:1373-1378.

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