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Aims/hypothesis: This study estimated the economic efficiency (1) of intensive blood glucose control and tight blood pressure control in patients with type 2 diabetes who also had hypertension, and (2) of metformin therapy in type 2 diabetic patients who were overweight. Methods: We conducted cost-utility analysis based on patient-level data from a randomised clinical controlled trial involving 4,209 patients with newly diagnosed type 2 diabetes conducted in 23 hospital-based clinics in England, Scotland and Northern Ireland as part of the UK Prospective Diabetes Study (UKPDS). Three different policies were evaluated: intensive blood glucose control with sulphonylurea/insulin; intensive blood glucose control with metformin for overweight patients; and tight blood pressure control of hypertensive patients. Incremental cost:effectiveness ratios were calculated based on the net cost of healthcare resources associated with these policies and on effectiveness in terms of quality-adjusted life years gained, estimated over a lifetime from within-trial effects using the UKPDS Outcomes Model. Results: The incremental cost per quality-adjusted life years gained (in year 2004 UK prices) for intensive blood glucose control was £6,028, and for blood pressure control was £369. Metformin therapy was cost-saving and increased quality-adjusted life expectancy. Conclusions/interpretation: Each of the three policies evaluated has a lower cost per quality-adjusted life year gained than that of many other accepted uses of healthcare resources. The results provide an economic rationale for ensuring that care of patients with type 2 diabetes corresponds at least to the levels of these interventions. © Springer-Verlag 2005.

Original publication

DOI

10.1007/s00125-005-1717-3

Type

Journal article

Journal

Diabetologia

Publication Date

01/05/2005

Volume

48

Pages

868 - 877