COST-EFFECTIVENESS ANALYSIS OF TYPE 2 DIABETES IN OUTPATIENT THERAPY IN TURKEY/TIP 2 DIYABETTE AYAKTAN TEDAVIDE MALIYET ETKINLIK ANALIZI

• Published in: İstanbul Tıp Fakültesi dergisi = Journal of the Istanbul Faculty of Medicine Vol. 80; no. 3; p. 92
• Main Authors: Yürüyen, Gülden, ÇIl, Eylem Özgün, Arman, Yücel, DemIr, Pinar, Çakmak, Ramazan, Akcan, Tugçe, Özcan, Mustafa, Akarsu, Murat, Altun, Özgür, Aydin YoldemIr, Sengül, Kirna, Kerem, Toprak, Ilkim Deniz, Tükek, Tufan
• Format: Journal Article
• Language: English
• Published: AVES 01.09.2017
• Subjects: Comparative analysis; Cost benefit analysis; Diabetes therapy; Diabetics; Economic aspects; Glycosylated hemoglobin; Health care costs; Insulin; Medical research; Type 2 diabetes
• ISSN: 1305-6433

Objective: The purpose of this study is to estimate the cost-effectiveness of screening, treatment, and examination of patients with type 2 diabetes during a yearly period and expose its importance in diabetes control. Materials and Methods: Five hundred patients with type 2 diabetes who had received outpatient therapy in the past year were enrolled in the study. Patients were divided into three categories according to their hemoglobin A1c (HbA1c) (%) levels: good control (HbA1c <7%), fair control (HbA1c 7%-10%), and poor control (HbA1c >10%). Average annual costs of treatment, examination, and laboratory workup were compared for the three groups. Results: The average annual cost of medication for 500 type 2 diabetes patients was $556.50, while the cost of screening and examination was $89.20 per patient. The average yearly treatment cost per patient was $287.90 for patients with HbA1c [less than or equal to]7%, $647.90 for patients with HbA1c 7%-10%, and $752.40 patients with HbA1c [greater than or equal to]10%. The average annual costs of treatment with only oral anti-diabetic drugs (OAD), insulin only, and both OAD and insulin were $154.80, $837.50, and $819.30, respectively. Conclusion: While the cost to treat diabetic patients with good control was significantly lower than the treatment cost of patients with poor control, there was no significant difference in laboratory workup and examination costs. When patients treated with OAD only, insulin only and OAD + insulin were compared, treatment costs for the OAD only group were significantly lower than the costs to treat the insulin only and OAD + insulin groups. No correlation between age or sex and medication cost were found. However, a strong correlation was found between diabetes duration and treatment cost. Keywords: Diabetes mellitus type 2; cost effectiveness; healthcare costs Amaç: Çalismamizin amaci; bir yillik süre içerisinde takip ettigimiz tip 2 diyabetik hastalarin tedavi, tetkik ve muayene için harcanan maliyetlerini ortaya koyup, bu maliyetlerin bir yillik kontrolde ne kadar etkili oldugunu göstermektir. Gereç ve Yöntem: Son bir yil içinde Tip 2 Diyabet tanisi ile poliklinigimizde ayaktan takip edilen 500 hasta çalismaya alindi. HbA1c (%) degerlerine göre 'iyi regüle [less than or equal to]7', 'kötü regüle7-10', 'çok kötü regüle [greater than or equal to]10' olmak üzere 3 gruba ayrildi ve üç grubun ortalama yillik tedavi, muayene ve tahlil maliyetleri hesaplanarak karsilastirmalari yapildi. Bulgular: Son bir yildir poliklinikte takip edilen 500 Tip 2 Diyabet tanisi olan hastanin bir yillik ilaç maliyeti ortalamasi kisi basi 1614 TL, ortalama muayene ve tahlil maliyeti ise 250 TL olarak hesaplandi. HbA1c [less than or equal to]7 olan hastalarda bir yillik ortalama tedavi maliyeti 835 TL, HbA1c 7-10 arasinda olan hastalarda 1879 TL iken, HbA1c [greater than or equal to]10 olan hastalarda ise 2182 TL saptandi. Sadece oral antidiyabetik (OAD) kullanan grubun bir yillik ortalama ilaç maliyeti 449 TL iken bu deger insulin kullanan grupta: 2429 TL ve OAD+insülin grubunda ise 2376 TL saptandi. Sonuç: Tedavi maliyetleri açisindan degerlendirildiginde iyi kontrollü diyabetik hastalarin tedavi maliyetleri, kötü kontrollü hastalardan anlamli olarak daha düsük iken, iki grup arasinda muayene ve tahlil harcamalarinda anlamli fark saptanmadi. OAD kullanan grup ile insülin ve OAD+insülin kullanan gruplar karsilastirildiginda, OAD kullanan grubun tedavi maliyeti diger iki grubun maliyetinden anlamli olarak düsük tespit edildi. Yas ve cinsiyet ile diyabet ilaç maliyeti arasinda korelasyon yokken, diyabet yasi ile tedavi maliyeti arasinda istatiksel olarak anlamli korelasyon saptandi. Anahtar Kelimeler: Tip 2 diabetes mellitus; maliyet etkinlik; tibbi bakim maliyeti