Ray Joshua A, Valentine William J, Secnik Kristina, Oglesby Alan K, Cordony Anna, Gordois Adam, Davey Peter, Palmer Andrew J
CORE--Center for Outcomes Research, Binningen/Basel, Switzerland.
Curr Med Res Opin. 2005 Oct;21(10):1617-29. doi: 10.1185/030079905X65349.
To provide a comprehensive source document on previously published cost data for diabetic complications in Australia, Canada, France, Germany, Italy and Spain for use in a peer-reviewed, validated diabetes model.
A search for published cost of diabetes complications data was performed in peer-reviewed journals listed in PubMed and health economic conference proceedings from 1994 to March 2005. Where country specific data were not available, we referred to government websites and local cost experts. All costs were inflated to 2003 Euros (E). Major complication costs are presented.
First year costs of non-fatal myocardial infarction varied between E19277 in Spain and E12292 in Australia. In subsequent years of treatment, this range was E1226 (France) to E203 (Australia). Angina costs were similar across all four countries: E1716 in Australia; E2218 in Canada; E2613 in France; E3342 in Germany; E2297 in Italy; and E2207 in Spain. Event costs of non-fatal stroke were higher in Canada (E23173) than in other countries (Australia E13443; France E11754; Germany E19399; Italy E6583; Spain E4638). Event costs of end-stage renal disease varied depending on the type of dialysis: in Australia (E17188-27552); Canada (E33811-58159); France (E24608-56487); Germany (E46296-68175); Italy (E43075-56717); and Spain (E28370-32706). Lower extremity amputation costs were: E18547 (Australia); E17130 (Canada); E31998 (France); E22096 (Germany); E10177 (Italy); and E14787 (Spain).
Overall, our search showed costs are well documented in Australia, Canada, France and Germany, but revealed a paucity of data for Spain and Italy. Spanish costs, collected by contacting local experts and from government reports, generally appeared to be lower for treating cardiovascular complications than in other countries. Italian costs reported in the literature were primarily hospitalization costs derived from diagnosis-related groups, and therefore likely to misrepresent the cost of specific complications. Additional research is required to document complication costs in Spain and Italy. Australian and German values were collected primarily by referring to diagnostic related group (DRG) tariffs and, as a result, there may be a need for future economic evaluations measuring the accuracy of the costs and resource utilization in the reported values. These cost data are essential to create models of diabetes that are able to accurately simulate the cumulative costs associated with the progression of the disease and its complications.
提供一份关于澳大利亚、加拿大、法国、德国、意大利和西班牙已发表的糖尿病并发症成本数据的综合原始文献，以供在经过同行评审且经验证的糖尿病模型中使用。
在1994年至2005年3月期间PubMed列出的同行评审期刊以及卫生经济会议论文集中搜索已发表的糖尿病并发症成本数据。若无法获取特定国家的数据，我们参考了政府网站和当地成本专家的意见。所有成本均折算为2003年欧元（€）。列出了主要并发症的成本。
非致命性心肌梗死的首年成本在西班牙为19277欧元，在澳大利亚为12292欧元。在后续治疗年份中，这一范围为法国的1226欧元至澳大利亚的203欧元。四个国家的心绞痛成本相似：澳大利亚为1716欧元；加拿大为2218欧元；法国为2613欧元；德国为3342欧元；意大利为2297欧元；西班牙为2207欧元。加拿大非致命性中风的事件成本（23173欧元）高于其他国家（澳大利亚为13443欧元；法国为11754欧元；德国为19399欧元；意大利为6583欧元；西班牙为4638欧元）。终末期肾病的事件成本因透析类型而异：澳大利亚为17188 - 27552欧元；加拿大为33811 - 58159欧元；法国为24608 - 56487欧元；德国为46296 - 68175欧元；意大利为43075 - 56717欧元；西班牙为28370 - 32706欧元。下肢截肢成本分别为：澳大利亚18547欧元；加拿大17130欧元；法国31998欧元；德国22096欧元；意大利10177欧元；西班牙14787欧元。
总体而言，我们的搜索表明澳大利亚、加拿大、法国和德国的成本记录完备，但西班牙和意大利的数据较少。通过联系当地专家和政府报告收集的西班牙成本数据显示，治疗心血管并发症的成本通常低于其他国家。文献中报道的意大利成本主要是来自诊断相关组的住院成本，因此可能无法准确反映特定并发症的成本。需要进一步研究以记录西班牙和意大利的并发症成本。澳大利亚和德国的数据主要通过参考诊断相关组（DRG）收费标准收集，因此未来可能需要进行经济评估，以衡量所报告成本和资源利用的准确性。这些成本数据对于创建能够准确模拟与疾病进展及其并发症相关的累积成本的糖尿病模型至关重要。
