Unit of PharmacoTherapy, Epidemiology & Economics (PTE2), Department of Pharmacy, University of Groningen, Groningen, the Netherlands.
Asc Academics, Groningen, the Netherlands.
PLoS One. 2019 Sep 6;14(9):e0221856. doi: 10.1371/journal.pone.0221856. eCollection 2019.
Type 2 diabetes mellitus (T2DM) is an established risk factor for cardiovascular and nephropathic events. In the Netherlands, prevalence of T2DM is expected to be as high as 8% by 2025. This will result in significant clinical and economic impact, highlighting the need for well-informed reimbursement decisions for new treatments. However, availability and consistent use of costing methodologies is limited.
We aimed to systematically review recent costing data for T2DM-related cardiovascular and nephropathic events in the Netherlands.
A systematic literature review in PubMed and Embase was conducted to identify available Dutch cost data for T2DM-related events, published in the last decade. Information extracted included costs, source, study population, and costing perspective. Finally, papers were evaluated using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS).
Out of initially 570 papers, 36 agreed with the inclusion criteria. From these studies, 150 cost estimates for T2DM-related clinical events were identified. In total, 29 cost estimates were reported for myocardial infarction (range: €196-€27,038), 61 for stroke (€495-€54,678), fifteen for heart failure (€325-€16,561), 24 for renal failure (€2,438-€91,503), and seventeen for revascularisation (€3,000-€37,071). Only four estimates for transient ischaemic attack were available, ranging from €587 to €2,470. Adherence to CHEERS was generally high.
The most expensive clinical events were related to renal failure, while TIA was the least expensive event. Generally, there was substantial variation in reported cost estimates for T2DM-related events. Costing of clinical events should be improved and preferably standardised, as accurate and consistent results in economic models are desired.
2 型糖尿病（T2DM）是心血管和肾病事件的既定危险因素。预计到 2025 年，荷兰的 T2DM 患病率将高达 8%。这将带来重大的临床和经济影响，凸显了为新疗法做出明智报销决策的必要性。然而，成本核算方法的可用性和一致性有限。
我们旨在系统回顾最近荷兰与 T2DM 相关的心血管和肾病事件的成本数据。
在 PubMed 和 Embase 中进行了系统文献综述，以确定过去十年中发表的与 T2DM 相关事件有关的可用荷兰成本数据。提取的信息包括成本、来源、研究人群和成本视角。最后，使用统一健康经济评估报告标准（CHEERS）对论文进行评估。
最初的 570 篇论文中，有 36 篇符合纳入标准。从这些研究中，确定了 150 项与 T2DM 相关临床事件有关的成本估算。总共报告了 29 项与心肌梗死相关的成本估算（范围：€196-€27,038），61 项与中风相关的成本估算（€495-€54,678），15 项与心力衰竭相关的成本估算（€325-€16,561），24 项与肾衰竭相关的成本估算（€2,438-€91,503），以及 17 项与血运重建相关的成本估算（€3,000-€37,071）。仅有四项短暂性脑缺血发作的估算，范围从€587 到€2,470。对 CHEERS 的遵守情况通常很高。
最昂贵的临床事件与肾衰竭有关，而 TIA 是最便宜的事件。一般来说，T2DM 相关事件的报告成本估算存在很大差异。应改进临床事件的成本核算，并最好进行标准化，因为在经济模型中需要准确且一致的结果。
