Hood S C, Annemans L, Rutten-van Mölken M
HEDM Research & Consulting, Mechelen, Belgium.
Pharmacoeconomics. 1998 Mar;13(3):317-26. doi: 10.2165/00019053-199813030-00006.
A short term (6-month) cost-effectiveness model has been developed to simulate current medical practice and disease progression in patients with type 2 (non-insulin-dependent) diabetes mellitus uncontrolled by diet and exercise. The model is based on decision-analytical techniques and includes probabilities of switching between treatments, the reason for the switch and the most common switch options. Effectiveness and economic measures are the 2 main outcomes. In order to assess effectiveness, we use symptom-free days with acceptable control (SFDACs), which represent each day of treatment without adverse events or symptoms, and with acceptable control of glucose and lipids. For the economic evaluation, only incremental costs incurred directly by a health insurance system are considered. This model should prove useful in the evaluation of new oral antidiabetic agents, since the short term aim of antidiabetic therapy is to provide adequate control in the absence of adverse effects and symptoms (a prerequisite for successful long term treatment). Furthermore, short term analysis provides data for comparing initial investment in drug therapy with potential savings over a longer treatment period.
已开发出一种短期（6个月）成本效益模型，以模拟当前对饮食和运动控制不佳的2型（非胰岛素依赖型）糖尿病患者的医疗实践和疾病进展。该模型基于决策分析技术，包括治疗之间转换的概率、转换原因以及最常见的转换选项。有效性和经济指标是两个主要结果。为了评估有效性，我们使用可接受控制下的无症状天数（SFDACs），即治疗期间无不良事件或症状且血糖和血脂得到可接受控制的每一天。对于经济评估，仅考虑医疗保险系统直接产生的增量成本。该模型在评估新型口服抗糖尿病药物方面应会证明有用，因为抗糖尿病治疗的短期目标是在无不良反应和症状的情况下提供充分控制（这是长期成功治疗的先决条件）。此外，短期分析提供了数据，可用于比较药物治疗的初始投资与较长治疗期内的潜在节省。
