Abstract

PINOL, Carme; ROZE, Stephane; VALENTINE, William  and  EVERS, Thomas. Cost-effectiveness of the addition of acarbose to the treatment of patients with type-2 diabetes in Spain. Gac Sanit [online]. 2007, vol.21, n.2, pp.97-104. ISSN 0213-9111.

Objectives: To assess the cost-effectiveness of the addition of acarbose to existing treatment in patients with type 2 diabetes mellitus (DM2) in Spain. Methods: The CORE Diabetes Model (a published and validated computer simulation model) was used to project long-term clinical and cost outcomes in DM2. Transition probabilities and risk adjustments were derived from published sources. Treatment effects and baseline cohort characteristics were based on a meta-analysis. Direct costs were retrieved from published sources and projected over patient lifetimes from the perspective of the Spanish National Health Service. Costs and clinical benefits were discounted at 3% per year. Sensitivity analyses were performed. Results: Acarbose treatment was associated with improved life expectancy (0.23 years) and quality-adjusted life years (QALY) (0.21 years). Direct costs were on average € 468 per patient more expensive with acarbose than with placebo. The incremental cost-effectiveness ratios were € 2,002 per life year gained and € 2,199 per QALY gained. An acceptability curve showed that with a willingness to pay € 20,000, which is generally accepted to represent very good value for money, acarbose treatment was associated with a 93.5% probability of being cost-effective. Conclusions: This long-term economic study showed that the addition of acarbose to existing therapy for DM2 was associated with improvements in life expectancy and QALYs in these patients.

Keywords : Cost-effectiveness; Type 2 diabetes; Acarbose; Quality-adjusted life years.

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