Table 6: Summary of Published Cost-Effectiveness Analyses [28]

Study and setting(s)

Year of Costs

Methods

Findings

 

Sweden [32]

2003 (SEK)

Within trial cost-effectiveness analysis of acarbose, based on STOP-NIDDM, 40 month time horizon, projected total direct costs based on progression to T2DM or cardiovascular disease.

Acarbose dominant to placebo for high risk groups.

Canada [33]

2000 ($CD)

Markov model based on DPP, DPS and STOP-NIDDM, projected LE, diabetes-free years, and total direct lifetime costs, 10 year time horizon.

Acarbose and metformin dominant versus control, ILC cost-effective to control (ICER $749 per life year gained)

USA [11]

2000 ($US)

Within trial cost-effectiveness of DPP interventions (3 years), direct and indirect costs, extensive sensitivity analyses.

ILC cost-effective versus placebo. Significant improvements in economic benefits if implementation costs reduced.

USA [26]

2000 ($US)

Markov model, DPP and UKPDS data adapted to US setting, projected LE, QALE and total direct medical costs, lifetime time horizon, healthcare payer and societal perspectives taken.

ILC dominant versus metformin, metformin not cost-effective for over 65 years of age, outcomes sensitive to the pricing of treatments.

Australia, [34] France, Germany, Switzerland, UK

2002 (€)

Markov model, based on DPP, projected LE, years free of diabetes and total direct costs, lifetime time horizon, extensive sensitivity analyses and sub-group analyses on age and BMI.

ILC and metformin dominant versus control except UK (ICER €6,381 and 5,400 per life year gained, respectively)

  Italy[35]

2004 (€)

Markov model, based on DPP, adapted to italian setting, projected LE,years free of diabetes and total direct costs,lifetime time horizon.

ILC and metformin cost effective vs control (ICER   11,234  and 11,556 per life year gained,respectively)

Spain [36]

2004 (€)

Markov model, based on DPP, adapted to Spanish setting, projected LE, years free of diabetes and total direct costs, lifetime time horizon.

Metformin cost-effective versus control (ICER €5,080 per life year gained), IILC costs prohibitive due to personnel costs.

USA [37]

2005 ($US)

Archimedes model, based on ILC intervention from DPP, projected LE, total direct costs, 30 year time horizon.

ICER $62,602 and $35,523 for ILC and metformin versus control, respectively.