Vijgen Sylvia M C, Hoogendoorn Mirjam, Baan Caroline A, de Wit G Ardine, Limburg Wien, Feenstra Talitha L
Department for Prevention and Health Services Research, National Institute of Public Health and Environment (RIVM), Bilthoven, The Netherlands.
Pharmacoeconomics. 2006;24(5):425-41. doi: 10.2165/00019053-200624050-00002.
A systematic review of the literature was conducted to give an overview of economic evaluations of preventive interventions in type 2 diabetes mellitus. The interventions were sorted by type of preventive intervention (primary, secondary or tertiary) and by category (e.g. education, medication for hypertension). Several databases were searched for studies published between January 1990 and May 2004 on the three types of preventive intervention. For each study selected, inclusion of specific components from a standardised list of items, including quality, was recorded in a database. Summary tables were generated based on the database.A number of conclusions were drawn from this review. The most important was that strict blood pressure control was a more cost-effective intervention than less strict control, as shown by six studies reporting cost savings to very low costs per life-year gained. Primary and secondary prevention of type 2 diabetes were also highly cost effective, but these results were based on very few studies. Medications to reduce weight and hyperglycaemia together were cost effective compared with conventional interventions. Finally, the separate results regarding medications to reduce weight, hyperglycaemia and hypercholesterolaemia varied enormously, thus no conclusion could be drawn and further economic analysis is required.
对文献进行了系统综述，以概述2型糖尿病预防干预措施的经济学评价。干预措施按预防干预类型（一级、二级或三级）和类别（如教育、高血压用药）进行分类。检索了几个数据库，以查找1990年1月至2004年5月期间发表的关于这三种预防干预类型的研究。对于每项入选研究，将来自标准化项目列表（包括质量）的特定组成部分的纳入情况记录在一个数据库中。根据该数据库生成了汇总表。本次综述得出了一些结论。最重要的是，六项研究表明，严格控制血压比不太严格的控制更具成本效益，每获得一个生命年的成本节约至非常低的成本。2型糖尿病的一级和二级预防也具有很高的成本效益，但这些结果基于非常少的研究。与传统干预措施相比，联合使用减轻体重和高血糖的药物具有成本效益。最后，关于减轻体重、高血糖和高胆固醇血症药物的单独结果差异极大，因此无法得出结论，需要进一步进行经济学分析。
