Brennan Victoria K, Colosia Ann D, Copley-Merriman Catherine, Mauskopf Josephine, Hass Bastian, Palencia Roberto
RTI Health Solutions , Ann Arbor, MI , USA.
J Med Econ. 2014 Jul;17(7):469-80. doi: 10.3111/13696998.2014.915847. Epub 2014 May 2.
To identify cost estimates related to myocardial infarction (MI) or stroke in patients with type 2 diabetes mellitus (T2DM) for use in economic models.
A systematic literature review was conducted. Electronic databases and conference abstracts were screened against inclusion criteria, which included studies performed in patients who had T2DM before experiencing an MI or stroke. Primary cost studies and economic models were included. Costs were converted to 2012 pounds sterling.
Fifty-four studies were identified: 13 primary cost studies and 41 economic evaluations using secondary sources for complication costs. Primary studies provided costs from 10 countries. Estimates for a fatal event ranged from £2482-£5222 for MI and from £4900-£6694 for stroke. Costs for the year a non-fatal event occurred ranged from £5071-£29,249 for MI and from £5171-£38,732 for stroke. Annual follow-up costs ranged from £945-£1616 for an MI and from £4704-£12,926 for a stroke. Economic evaluations from 12 countries were identified, and costs of complications showed similar variability to the primary studies.
The costs identified within primary studies varied between and within countries. Many studies used costs estimated in studies not specific to patients with T2DM. Data gaps included a detailed breakdown of resource use, which affected the ability to compare data across countries.
In the development of economic models for patients with T2DM, the use of accurate estimates of costs associated with MI and stroke is important. When country-specific costs are not available, clear justification for the choice of estimates should be provided.
确定2型糖尿病（T2DM）患者心肌梗死（MI）或中风的成本估算，以用于经济模型。
进行了系统的文献综述。根据纳入标准对电子数据库和会议摘要进行筛选，纳入标准包括在发生MI或中风之前患有T2DM的患者中进行的研究。纳入了主要成本研究和经济模型。成本换算为2012年英镑。
共识别出54项研究：13项主要成本研究和41项使用并发症成本二级来源的经济评估。主要研究提供了来自10个国家的成本。致命事件的估算成本，MI为2482英镑至5222英镑，中风为4900英镑至6694英镑。非致命事件发生当年的成本，MI为5071英镑至29249英镑，中风为5171英镑至38732英镑。MI的年度随访成本为945英镑至1616英镑，中风为4704英镑至12926英镑。识别出了来自12个国家的经济评估，并发症成本显示出与主要研究相似的变异性。
主要研究中确定的成本在不同国家之间以及国家内部存在差异。许多研究使用的成本估算并非针对T2DM患者的研究。数据缺口包括资源使用的详细分类，这影响了跨国比较数据的能力。
在开发T2DM患者的经济模型时，使用与MI和中风相关成本的准确估算很重要。当没有特定国家的成本数据时，应提供选择估算值的明确理由。
