Cost-effectiveness analysis of a pharmacotherapeutic empowerment strategy for patients with type 2 diabetes mellitus
Background The economic feasibility of pharmacotherapeutic empowerment of patients with type 2 diabetes mellitus (DM2) is still not well established.Objectives To evaluate the cost-effectiveness of an individual pharmacotherapeutic empowerment strategy (IPES) for patients with DM2.Methods This is a...
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BMJ Publishing Group
2019-05-01
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| Series: | BMJ Open Diabetes Research & Care |
| Online Access: | https://drc.bmj.com/content/7/1/e000647.full |
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| author | Ana Carolina Oliveira Gonçalves Maurílio de Souza Cazarim Cristina Sanches Leonardo Regis Leira Pereira Ana Márcia Tomé Camargos Jéssica Azevedo Aquino Andre Oliveira Baldoni |
| author_facet | Ana Carolina Oliveira Gonçalves Maurílio de Souza Cazarim Cristina Sanches Leonardo Regis Leira Pereira Ana Márcia Tomé Camargos Jéssica Azevedo Aquino Andre Oliveira Baldoni |
| author_sort | Ana Carolina Oliveira Gonçalves |
| collection | DOAJ |
| description | Background The economic feasibility of pharmacotherapeutic empowerment of patients with type 2 diabetes mellitus (DM2) is still not well established.Objectives To evaluate the cost-effectiveness of an individual pharmacotherapeutic empowerment strategy (IPES) for patients with DM2.Methods This is a cost-effectiveness study nested in a non-randomized clinical trial with patients ≥18 years of age, of both genders, with low and moderate cardiovascular risks. This study was carried out from the perspective of the municipal health system of Divinópolis in Minas Gerais state, and compared patients submitted to an IPES and patients who received only traditional care, 1 year before the beginning of the intervention (baseline) and 1 year after its completion (follow-up). The costs of the services offered by the municipality were computed, and in the intervention group IPES costs were included. Glycated hemoglobin (A1c) was the effectiveness parameter adopted. Cost-effectiveness ratio analyses, incremental cost-effectiveness ratio (ICER), and sensitivity analysis were performed.Results In the analysis of cost-effectiveness, it is observed that a reduction of 0.359 in A1c costs US$708.47 in the intervention group and a reduction of 0.170 costs US$1927.13 in the control group. Thus, the ICER is US$387.66 per patient/year. In the sensitivity analysis, it was observed that the IPES was dominant in 19.8% of the simulated scenarios and cost-effective in 80.2%.Conclusions The IPES is an alternative that presents economic feasibility for the municipal public health system scenario. The absence of randomization in patient selection is a limitation of this study. |
| format | Article |
| id | doaj-art-97033c21182c466fa177511b3846dd73 |
| institution | OA Journals |
| issn | 2052-4897 |
| language | English |
| publishDate | 2019-05-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Diabetes Research & Care |
| spelling | doaj-art-97033c21182c466fa177511b3846dd732025-08-20T02:37:55ZengBMJ Publishing GroupBMJ Open Diabetes Research & Care2052-48972019-05-017110.1136/bmjdrc-2018-000647Cost-effectiveness analysis of a pharmacotherapeutic empowerment strategy for patients with type 2 diabetes mellitusAna Carolina Oliveira Gonçalves0Maurílio de Souza Cazarim1Cristina Sanches2Leonardo Regis Leira Pereira3Ana Márcia Tomé Camargos4Jéssica Azevedo Aquino5Andre Oliveira Baldoni6Universidade Federal de São João del-Rei - Campus CCO, Sao Joao del-Rei, BrazilFaculty of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil1 Federal University of São João del-Rei, Divinópolis, BrazilFaculty of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, BrazilFaculdade de Farmácia, Universidade Federal de Sao Joao del-Rei - Campus CCO, Sao Joao del-Rei, BrazilFaculdade de Farmácia, Universidade Federal de Sao Joao del-Rei - Campus CCO, Sao Joao del-Rei, BrazilFaculdade de Farmácia, Universidade Federal de Sao Joao del-Rei - Campus CCO, Sao Joao del-Rei, BrazilBackground The economic feasibility of pharmacotherapeutic empowerment of patients with type 2 diabetes mellitus (DM2) is still not well established.Objectives To evaluate the cost-effectiveness of an individual pharmacotherapeutic empowerment strategy (IPES) for patients with DM2.Methods This is a cost-effectiveness study nested in a non-randomized clinical trial with patients ≥18 years of age, of both genders, with low and moderate cardiovascular risks. This study was carried out from the perspective of the municipal health system of Divinópolis in Minas Gerais state, and compared patients submitted to an IPES and patients who received only traditional care, 1 year before the beginning of the intervention (baseline) and 1 year after its completion (follow-up). The costs of the services offered by the municipality were computed, and in the intervention group IPES costs were included. Glycated hemoglobin (A1c) was the effectiveness parameter adopted. Cost-effectiveness ratio analyses, incremental cost-effectiveness ratio (ICER), and sensitivity analysis were performed.Results In the analysis of cost-effectiveness, it is observed that a reduction of 0.359 in A1c costs US$708.47 in the intervention group and a reduction of 0.170 costs US$1927.13 in the control group. Thus, the ICER is US$387.66 per patient/year. In the sensitivity analysis, it was observed that the IPES was dominant in 19.8% of the simulated scenarios and cost-effective in 80.2%.Conclusions The IPES is an alternative that presents economic feasibility for the municipal public health system scenario. The absence of randomization in patient selection is a limitation of this study.https://drc.bmj.com/content/7/1/e000647.full |
| spellingShingle | Ana Carolina Oliveira Gonçalves Maurílio de Souza Cazarim Cristina Sanches Leonardo Regis Leira Pereira Ana Márcia Tomé Camargos Jéssica Azevedo Aquino Andre Oliveira Baldoni Cost-effectiveness analysis of a pharmacotherapeutic empowerment strategy for patients with type 2 diabetes mellitus BMJ Open Diabetes Research & Care |
| title | Cost-effectiveness analysis of a pharmacotherapeutic empowerment strategy for patients with type 2 diabetes mellitus |
| title_full | Cost-effectiveness analysis of a pharmacotherapeutic empowerment strategy for patients with type 2 diabetes mellitus |
| title_fullStr | Cost-effectiveness analysis of a pharmacotherapeutic empowerment strategy for patients with type 2 diabetes mellitus |
| title_full_unstemmed | Cost-effectiveness analysis of a pharmacotherapeutic empowerment strategy for patients with type 2 diabetes mellitus |
| title_short | Cost-effectiveness analysis of a pharmacotherapeutic empowerment strategy for patients with type 2 diabetes mellitus |
| title_sort | cost effectiveness analysis of a pharmacotherapeutic empowerment strategy for patients with type 2 diabetes mellitus |
| url | https://drc.bmj.com/content/7/1/e000647.full |
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