Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada.
Last Mile, Holte, Denmark.
Value Health. 2018 Jul;21(7):881-890. doi: 10.1016/j.jval.2017.12.019. Epub 2018 Feb 16.
Cardiovascular diseases (CVDs) constitute major comorbidities in type 2 diabetes mellitus (T2DM), contributing substantially to treatment costs for T2DM. An updated overview of the economic burden of CVD in T2DM has not been presented to date.
To systematically review published articles describing the costs associated with treating CVD in people with T2DM.
Two reviewers searched MEDLINE, Embase, and abstracts from scientific meetings to identify original research published between 2007 and 2017, with no restrictions on language. Studies reporting direct costs at either a macro level (e.g., burden of illness for a country) or a micro level (e.g., cost incurred by one patient) were included. Extracted costs were inflated to 2016 values using local consumer price indexes, converted into US dollars, and presented as cost per patient per year.
Of 81 identified articles, 24 were accepted for analysis, of which 14 were full articles and 10 abstracts. Cardiovascular comorbidities in patients with T2DM incurred a significant burden at both the population and patient levels. From a population level, CVD costs contributed between 20% and 49% of the total direct costs of treating T2DM. The median annual costs per patient for CVD, coronary artery disease, heart failure, and stroke were, respectively, 112%, 107%, 59%, and 322% higher compared with those for T2DM patients without CVD. On average, treating patients with CVD and T2DM resulted in a cost increase ranging from $3418 to $9705 compared with treating patients with T2DM alone.
Globally, CVD has a substantial impact on direct medical costs of T2DM at both the patient and population levels.
心血管疾病（CVDs）是 2 型糖尿病（T2DM）的主要合并症，对 T2DM 的治疗费用有重大影响。迄今为止，尚未对 T2DM 中 CVD 的经济负担进行最新的综述。
系统综述描述与 T2DM 患者 CVD 治疗相关费用的已发表文章。
两名审查员检索 MEDLINE、Embase 和科学会议摘要，以确定 2007 年至 2017 年期间发表的原始研究，对语言无任何限制。报告直接成本的研究包括宏观层面（例如，一个国家的疾病负担）或微观层面（例如，一个患者的成本）。提取的成本使用当地消费者物价指数换算为 2016 年的数值，换算为美元，并以每位患者每年的成本表示。
在 81 篇确定的文章中，24 篇被接受进行分析，其中 14 篇为全文，10 篇为摘要。T2DM 患者的心血管合并症在人群和患者层面均造成了显著的负担。从人群层面看，CVD 成本占 T2DM 总直接成本的 20%-49%。与无 CVD 的 T2DM 患者相比，CVD、冠状动脉疾病、心力衰竭和中风患者的年人均 CVD 成本分别高出 112%、107%、59%和 322%。平均而言，与单独治疗 T2DM 患者相比，治疗合并 CVD 和 T2DM 的患者会导致成本增加 3418 美元至 9705 美元。
在全球范围内，CVD 对 T2DM 患者和人群的直接医疗费用均有重大影响。
