Parekh Witesh, Hoskins Nicki, Baker-Knight James, Ramirez de Arellano Antonio, Mezquita Raya Pedro
European HEOR, Novo Nordisk Ltd., 3 City Place, Beehive Ring Road, Gatwick, UK.
DRG Abacus, Bicester, Oxfordshire, UK.
Diabetes Ther. 2017 Aug;8(4):899-913. doi: 10.1007/s13300-017-0285-0. Epub 2017 Jun 26.
An analysis was conducted to estimate the economic burden of insulin-related hypoglycemia in adults in Spain, derived from a novel concept developed for the UK known as the Local Impact of Hypoglycemia Tool.
Costs per severe and non-severe hypoglycemic episode were calculated for patients with type 1 diabetes (T1DM) and type 2 diabetes (T2DM). The costs per episode were applied to the population of adults with T1DM and T2DM using insulin in Spain according to the number of severe and non-severe episodes experienced per year. Costs were calculated using Spanish-specific resource costs and published values for resource utilization, including ambulance, accident and emergency (A&E) department, hospitalization, healthcare professional visits, and extra self-monitoring of blood glucose (SMBG) tests used in the week following the episode. A one-way sensitivity analysis on all model inputs was then performed.
The cost of insulin-related hypoglycemia in Spain is estimated as €662.0 m per year, €292.6 m of which is due to severe episodes and €369.4 m to non-severe episodes. The cost per episode varies from €1.25 for patients with T1DM and €1.48 for patients with T2DM for a non-severe episode where extra SMBG testing after the episode is the only action taken, to €4378.22 for T1DM and €3005.74 for T2DM for a severe episode that was treated in hospital and requires an ambulance, A&E visit, hospitalization, and a diabetes specialist visit. A reduction in severe and non-severe hypoglycemia rates of just 20% could lead to considerable cost savings of €284,925 per 100,000 general population.
This analysis highlights the substantial economic burden of hypoglycemia in Spain, and gives budget holders the ability to assess the costs of new treatments or patient education programs in relation to the potential cost savings due to lower hypoglycemia rates.
基于为英国开发的一个名为低血糖症局部影响工具的新概念，进行了一项分析以估算西班牙成年人中胰岛素相关低血糖症的经济负担。
计算了1型糖尿病（T1DM）和2型糖尿病（T2DM）患者严重和非严重低血糖发作的单次成本。根据西班牙每年使用胰岛素的T1DM和T2DM成年人群经历的严重和非严重发作次数，将单次成本应用于该人群。成本计算使用了西班牙特定的资源成本以及已公布的资源利用价值，包括救护车、急诊（A&E）科室、住院、医疗专业人员问诊以及发作后一周内额外的自我血糖监测（SMBG）检测。然后对所有模型输入进行了单向敏感性分析。
西班牙胰岛素相关低血糖症的成本估计为每年6.62亿欧元，其中2.926亿欧元归因于严重发作，3.694亿欧元归因于非严重发作。单次成本从非严重发作且发作后仅进行额外SMBG检测时T1DM患者的1.25欧元和T2DM患者的1.48欧元，到在医院治疗且需要救护车、急诊就诊、住院以及糖尿病专科就诊的严重发作时T1DM患者的4378.22欧元和T2DM患者的3005.74欧元不等。严重和非严重低血糖发生率仅降低20%，每10万普通人群就可节省可观的成本284,925欧元。
该分析突出了西班牙低血糖症的巨大经济负担，并使预算管理者能够评估新治疗方法或患者教育项目的成本，以及与较低低血糖发生率带来的潜在成本节省相关的情况。
