将疾病管理方案应用于 2 型糖尿病患者可延长其寿命，具有成本效益。
Life prolonging of disease management programs in patients with type 2 diabetes is cost-effective.
机构信息
Institute of Health Economics and Clinical Epidemiology, University Hospital Cologne, Gleueler Straße 176-178, 50935 Köln, Germany.
出版信息
Diabetes Res Clin Pract. 2012 Feb;95(2):194-200. doi: 10.1016/j.diabres.2011.09.015. Epub 2011 Oct 17.
AIM
Our objective was to examine the cost-effectiveness of disease management programs (DMPs) for type 2 diabetes mellitus (T2DM) taking into account their life prolonging effect.
METHODS
We compared real life costs in 19,888 propensity score matched pairs of T2DM DMP participants and T2DM patients in routine care (RC) according to sickness funds data. We estimated mean annual costs for survivors, last year of life costs for decedents, the influence of ageing on costs, incremental cost-effectiveness ratio and effects on hospitalization.
RESULTS
Annual costs for survivors were 3,318€ (DMP) and 3,570€ (RC). The mean costs in the last year of life were 16,911€ (DMP) and 15,763€ (RC). Ageing had a cost triggering effect for survivors (30€/36€ per year in DMP-/RC-group; p<0.001) and a cost decreasing effect in the last year of life (546€/483€ per year in DMP-/RC-group; p<0.001). The incremental cost-effectiveness ratio of the DMP vs. RC was -1396€ per life-year gained. Hospitalizations increased with age in case of survival and decreased with age in case of death but were always lower in the DMP-group.
CONCLUSION
Despite increase in costs due to longer life DMPs are cost-effective.
目的
本研究旨在考察考虑到延长寿命效果的情况下，2 型糖尿病（T2DM）疾病管理计划（DMP）的成本效益。
方法
根据疾病基金数据，我们比较了 19888 对 2 型糖尿病 DMP 参与者和常规护理（RC）中 2 型糖尿病患者的倾向性得分匹配对的实际生活成本。我们估计了幸存者的年平均成本、死亡者生命最后一年的成本、老龄化对成本的影响、增量成本效益比以及对住院的影响。
结果
幸存者的年成本分别为 3318 欧元（DMP）和 3570 欧元（RC）。生命最后一年的平均成本分别为 16911 欧元（DMP）和 15763 欧元（RC）。老龄化对幸存者具有成本触发效应（DMP-/RC-组每年分别增加 30 欧元/36 欧元；p<0.001），对生命最后一年具有成本降低效应（DMP-/RC-组每年分别减少 546 欧元/483 欧元；p<0.001）。与 RC 相比，DMP 的增量成本效益比为每获得 1 个生命年节省 1396 欧元。在生存情况下，随着年龄的增长，住院人数增加，而在死亡情况下，随着年龄的增长，住院人数减少，但在 DMP 组中，住院人数总是较低。
结论
尽管由于寿命延长导致成本增加，但 DMP 仍具有成本效益。
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