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

Introduction To assess the cost-effectiveness of a multidisciplinary and comprehensive innovative diabetes care program (CAIPaDi) versus usual treatment in public health institutions.Research design and methods Using a cost-effectiveness analysis, we compared the CAIPaDi program versus usual treatme...

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Main Authors: Enrique O Graue-Hernandez, Sergio Hernandez-Jimenez, David Kershenobich-Stalnikowitz, Ana Cristina García-Ulloa, Carlos Alberto Aguilar-Salinas, Denise Arcila-Martínez, Rodrigo Arizmendi-Rodríguez, Humberto Del Valle-Ramírez, Fernanda Garnica-Carrillo, Eduardo González-Flores, Mariana Granados-Arcos, Héctor Infanzón-Talango, Claudia Lechuga-Fonseca, Liliana Pérez-Peralta, David Rivera de la Parra, Sofía Ríos-Villavicencio, Francis Rojas-Torres, Sandra Sainos-Muñoz, Alejandra Sierra-Esquivel, Luz Elena Urbina-Arronte, María Luisa Velasco-Pérez, Héctor Velázquez-Jurado, Andrea Villegas-Narváez, Verónica Zurita-Cortés, María Teresa Alcántara-Garcés, Michelle Díaz-Pineda, Arturo Flores García, María Victoria Landa-Anell, Marco Antonio Melgarejo-Hernández, Pablo Anaya, Ricardo Gasca-Pineda, Luis Arturo Sánchez-Trujillo, Héctor Peña Baca, Eduardo González-Pier, Franciso Javier Gómez-Pérez, Angélica Palacios-Vargas, Diana Hernández-Juárez, Arely Hernández-Jasso
Format: Article
Language:English
Published: BMJ Publishing Group 2021-03-01
Series:BMJ Open Diabetes Research & Care
Online Access:https://drc.bmj.com/content/9/1/e002097.full
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author Enrique O Graue-Hernandez
Sergio Hernandez-Jimenez
David Kershenobich-Stalnikowitz
Ana Cristina García-Ulloa
Carlos Alberto Aguilar-Salinas
Denise Arcila-Martínez
Rodrigo Arizmendi-Rodríguez
Humberto Del Valle-Ramírez
Fernanda Garnica-Carrillo
Eduardo González-Flores
Mariana Granados-Arcos
Héctor Infanzón-Talango
Claudia Lechuga-Fonseca
Liliana Pérez-Peralta
David Rivera de la Parra
Sofía Ríos-Villavicencio
Francis Rojas-Torres
Sandra Sainos-Muñoz
Alejandra Sierra-Esquivel
Luz Elena Urbina-Arronte
María Luisa Velasco-Pérez
Héctor Velázquez-Jurado
Andrea Villegas-Narváez
Verónica Zurita-Cortés
María Teresa Alcántara-Garcés
Michelle Díaz-Pineda
Arturo Flores García
María Victoria Landa-Anell
Marco Antonio Melgarejo-Hernández
Pablo Anaya
Ricardo Gasca-Pineda
Luis Arturo Sánchez-Trujillo
Héctor Peña Baca
Eduardo González-Pier
Franciso Javier Gómez-Pérez
Angélica Palacios-Vargas
Diana Hernández-Juárez
Arely Hernández-Jasso
author_facet Enrique O Graue-Hernandez
Sergio Hernandez-Jimenez
David Kershenobich-Stalnikowitz
Ana Cristina García-Ulloa
Carlos Alberto Aguilar-Salinas
Denise Arcila-Martínez
Rodrigo Arizmendi-Rodríguez
Humberto Del Valle-Ramírez
Fernanda Garnica-Carrillo
Eduardo González-Flores
Mariana Granados-Arcos
Héctor Infanzón-Talango
Claudia Lechuga-Fonseca
Liliana Pérez-Peralta
David Rivera de la Parra
Sofía Ríos-Villavicencio
Francis Rojas-Torres
Sandra Sainos-Muñoz
Alejandra Sierra-Esquivel
Luz Elena Urbina-Arronte
María Luisa Velasco-Pérez
Héctor Velázquez-Jurado
Andrea Villegas-Narváez
Verónica Zurita-Cortés
María Teresa Alcántara-Garcés
Michelle Díaz-Pineda
Arturo Flores García
María Victoria Landa-Anell
Marco Antonio Melgarejo-Hernández
Pablo Anaya
Ricardo Gasca-Pineda
Luis Arturo Sánchez-Trujillo
Héctor Peña Baca
Eduardo González-Pier
Franciso Javier Gómez-Pérez
Angélica Palacios-Vargas
Diana Hernández-Juárez
Arely Hernández-Jasso
author_sort Enrique O Graue-Hernandez
collection DOAJ
description Introduction To assess the cost-effectiveness of a multidisciplinary and comprehensive innovative diabetes care program (CAIPaDi) versus usual treatment in public health institutions.Research design and methods Using 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 prospectively 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.Results The 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.Conclusions CAIPaDi has a better cost-effectiveness ratio than the usual therapy in Mexican public health institutions.
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spelling doaj-art-52b8ea1daec1424f94913b77c1e1dbdf2025-08-20T02:34:33ZengBMJ Publishing GroupBMJ Open Diabetes Research & Care2052-48972021-03-019110.1136/bmjdrc-2020-002097Cost-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 CityEnrique O Graue-Hernandez0Sergio Hernandez-Jimenez1David Kershenobich-Stalnikowitz2Ana Cristina García-Ulloa3Carlos Alberto Aguilar-Salinas4Denise Arcila-MartínezRodrigo Arizmendi-RodríguezHumberto Del Valle-RamírezFernanda Garnica-Carrillo5Eduardo González-FloresMariana Granados-ArcosHéctor Infanzón-TalangoClaudia Lechuga-FonsecaLiliana Pérez-PeraltaDavid Rivera de la ParraSofía Ríos-VillavicencioFrancis Rojas-TorresSandra Sainos-MuñozAlejandra Sierra-EsquivelLuz Elena Urbina-ArronteMaría Luisa Velasco-PérezHéctor Velázquez-JuradoAndrea Villegas-NarváezVerónica Zurita-CortésMaría Teresa Alcántara-GarcésMichelle Díaz-Pineda6Arturo Flores GarcíaMaría Victoria Landa-AnellMarco Antonio Melgarejo-HernándezPablo Anaya7Ricardo Gasca-Pineda8Luis Arturo Sánchez-Trujillo9Héctor Peña Baca10Eduardo González-Pier11Franciso Javier Gómez-Pérez12Angélica Palacios-VargasDiana Hernández-JuárezArely Hernández-JassoDepartment of Cornea and Refractive Surgery, Instituto de Oftalmología Fundación Conde de Valenciana IAP, Mexico City, MexicoCentro de Atención Integral del Paciente con Diabetes, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran Departamento Endocrinologia y Metabolismo, Tlalpan, MexicoNational Institute of Medical Sciences and Nutrition Salvador Zubiran, Tlalpan, MexicoCAIPaDi, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Tlalpan, MexicoInstituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoCentro de Atención Integral del Paciente con Diabetes, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran Departamento Endocrinologia y Metabolismo, Tlalpan, MexicoCentro de Atención Integral del Paciente con Diabetes, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran Departamento Endocrinologia y Metabolismo, Tlalpan, MexicoIQVIA, Fairfax, Virginia, USAReal-World Insights, IQVIA, Mexico City, MexicoReal-World Insights, IQVIA, Mexico City, MexicoBlutitude Health Care Intelligence, Mexico City, MexicoBlutitude Health Care Intelligence, Mexico City, MexicoEndocrinology and Metabolism, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Tlalpan, MexicoIntroduction To assess the cost-effectiveness of a multidisciplinary and comprehensive innovative diabetes care program (CAIPaDi) versus usual treatment in public health institutions.Research design and methods Using 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 prospectively 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.Results The 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.Conclusions CAIPaDi has a better cost-effectiveness ratio than the usual therapy in Mexican public health institutions.https://drc.bmj.com/content/9/1/e002097.full
spellingShingle Enrique O Graue-Hernandez
Sergio Hernandez-Jimenez
David Kershenobich-Stalnikowitz
Ana Cristina García-Ulloa
Carlos Alberto Aguilar-Salinas
Denise Arcila-Martínez
Rodrigo Arizmendi-Rodríguez
Humberto Del Valle-Ramírez
Fernanda Garnica-Carrillo
Eduardo González-Flores
Mariana Granados-Arcos
Héctor Infanzón-Talango
Claudia Lechuga-Fonseca
Liliana Pérez-Peralta
David Rivera de la Parra
Sofía Ríos-Villavicencio
Francis Rojas-Torres
Sandra Sainos-Muñoz
Alejandra Sierra-Esquivel
Luz Elena Urbina-Arronte
María Luisa Velasco-Pérez
Héctor Velázquez-Jurado
Andrea Villegas-Narváez
Verónica Zurita-Cortés
María Teresa Alcántara-Garcés
Michelle Díaz-Pineda
Arturo Flores García
María Victoria Landa-Anell
Marco Antonio Melgarejo-Hernández
Pablo Anaya
Ricardo Gasca-Pineda
Luis Arturo Sánchez-Trujillo
Héctor Peña Baca
Eduardo González-Pier
Franciso Javier Gómez-Pérez
Angélica Palacios-Vargas
Diana Hernández-Juárez
Arely Hernández-Jasso
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
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
url https://drc.bmj.com/content/9/1/e002097.full
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