Improving outcomes with early and intensive metabolic control in patients with type 2 diabetes: a long-term modeling analysis of clinical and cost outcomes in Italy.

OBJECTIVES

This analysis quantifies the potential long-term clinical and cost benefits of early and intensive metabolic control (EIMC) versus conventional management in patients newly diagnosed with type 2 diabetes in Italy.

METHODS

The PRIME T2D Model was used to project clinical and cost outcomes over long-term time horizons for a newly diagnosed cohort of patients receiving EIMC or conventional management. EIMC was associated with a mean glycated hemoglobin reduction of 0.6% from baseline and a mean weight loss of 9.5 kg (8.2%) for a duration of 6 years, before gradually returning to the same levels as the conventional management arm over 6 years. Modifiable risk factors were assumed to progress over time based on published regression functions. Direct and indirect costs associated with diabetes-related complications were accounted in 2021 Euros (EUR), with unit costs and health state utilities derived from published sources. Future costs and clinical benefits were discounted at 3% annually.

RESULTS

For the population diagnosed with type 2 diabetes in 2021 (estimated at 216,417 cases), EIMC was projected to add approximately 33,112 years of life and 55,403 quality-adjusted life years versus conventional management. Cost savings with EIMC were estimated at EUR 494 million, EUR 608 million and EUR 628 million in the incident population at 10- and 20- and 50-year time horizons, respectively.

CONCLUSIONS

According to this modeling study, early and intensive metabolic control has the potential to substantially improve clinical outcomes and reduce economic burden compared with conventional management of patients with type 2 diabetes in Italy.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40200-024-01553-w.