Challenges in funding diabetes care: A health economic perspective

Expert Review of Pharmacoeconomics and Outcomes Research

Volumn 10, Issue 5, 2010, Pages 517-524

  Weber, Christian ^a  

^a Ernst Basler and Partner Inc   (Switzerland)

Author keywords

ceiling ratio; cost of illness; cost effectiveness; diabetes mellitus; health economics; health technology assessment; low and middle income countries

Indexed keywords

HEMOGLOBIN A1C; INSULIN; ORAL ANTIDIABETIC AGENT;

ABSENTEEISM; BIOMEDICAL TECHNOLOGY ASSESSMENT; COST EFFECTIVENESS ANALYSIS; DEVELOPING COUNTRY; DIABETES EDUCATION; DIABETES MELLITUS; HEALTH CARE ACCESS; HEALTH CARE COST; HEALTH CARE DELIVERY; HEALTH CARE FINANCING; HEALTH ECONOMICS; HEMOGLOBIN BLOOD LEVEL; HUMAN; IMPAIRED GLUCOSE TOLERANCE; INSULIN DEPENDENT DIABETES MELLITUS; LIFESTYLE MODIFICATION; MEDICAL INSTRUMENTATION; MORBIDITY; NON INSULIN DEPENDENT DIABETES MELLITUS; PATIENT COUNSELING; PREVALENCE; PRODUCTIVITY; PUBLIC HEALTH; QUALITY OF LIFE; RESOURCE MANAGEMENT; REVIEW;

COST OF ILLNESS; COST-BENEFIT ANALYSIS; DEVELOPING COUNTRIES; DIABETES MELLITUS, TYPE 1; DIABETES MELLITUS, TYPE 2; HUMANS; TECHNOLOGY ASSESSMENT, BIOMEDICAL;

EID: 77958197117     PISSN: 14737167     EISSN: 17448379     Source Type: Journal    
DOI: 10.1586/erp.10.48     Document Type: Review

References (89)

1. IDF Diabetes Atlas. International Diabetes Federation (4th Edition). International Diabetes Federation, Brussels, Belgium (2009). •• The most comprehensive overview on the epidemiology and the economics of diabetes mellitus in different countries worldwide.
2. American diabetes association. Economic costs of diabetes in the U. S. in 2007. Diabetes Care 31(3), 1-20 (2008).
3. Schnell O, Hummel M, Weber C. Economic and clinical aspects of diabetes regarding self-monitoring of blood glucose. Diabetes Technol. Ther. 10 (Suppl. 1), S72-S81 (2008).
4. International Bank for Reconstruction and Development, The World Bank. (2005) International Comparision Program. Preliminary Results. The World Bank, Washington DC, USA (2007).
5. Zhang PP, Engelgau MMM, Norris SLM et al. Application of economic analysis to diabetes and diabetes care. Ann. Intern. Med. 140(11), 972-977 (2004).
6. Cefalu W. Economics of diabetes - cost impact of not treating diabetes early and intensively. Clin. Cornerstone 6(2), 51-58 (2004).
7. Goldfarb N, Weston C, Hartmann CW et al. Impact of appropriate pharmaceutical therapy for chronic conditions on direct medical costs and workplace productivity: a review of the literature. Dis. Manag. 7(1), 61-75 (2004).
8. Tuomilehto J, Lindstrom J, Eriksson JG et al. Prevention of Type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N. Engl. J. Med. 344(18), 1343-1350 (2001).
9. Gaede P, Lund-Andersen H, Parving HH, Pedersen O. Effect of a multifactorial intervention on mortality in Type 2 diabetes. N. Engl. J. Med. 358(6), 580-591 (2008).
10. Ribisl PM, Lang W, Jaramillo SA et al. Exercise capacity and cardiovascular/metabolic characteristics of overweight and obese individuals with Type 2 diabetes: the Look AHEAD clinical trial. Diabetes Care 30(10), 2679-2684 (2007).
11. Loveman E, Frampton GK, Clegg AJ. The clinical effectiveness of diabetes education models for Type 2 diabetes: a systematic review. Health Technol. Assess. 12(9), 1-116 (2008).
12. Christensen NK, Williams P, Pfister R. Cost Savings and clinical effectiveness of an extension service diabetes program. Diabetes Spectr. 17(3), 171-175 (2004).
13. Mortimer D, Kelly J. Economic evaluation of the good life club intervention for diabetes self-management. Aus. J. Primary Health 12(1), 91-100 (2006).
14. IDF Clinical Guidelines Task Force. Global Guideline for Type 2 Diabetes. International Diabetes Federation, Brussels, Belgium (2005).
15. American Diabetes Association. Standards of medical care in diabetes - 2009. Diabetes Care 32 (Suppl. 1), S13-S61 (2009).
16. National Collaborating Centre For Chronic Conditions. Type 2 Diabetes: National Clinical Guideline for Management in Primary and Secondary Care (Update). Royal College of Physicians, London, UK (2009).
17. Colagiuri S, Dickinson S, Girgis S, Colagiuri R. National Evidence Based Guideline for Blood Glucose Control in Type 2 Diabetes. Diabetes Australia and the NHMRC. Canberra, ACT, Australia (2009).
18. Pagano E, Brunetti M, Tediosi F, Garattini L. Costs of diabetes. A methodological analysis of the literature. Pharmacoeconomics 15(6), 583-595 (1999).
19. Brouwer WB, Koopmanschap MA. How to calculate indirect costs in economic evaluations. Pharmacoeconomics 13 (5 Pt 1), 563-569 (1998).
20. DCCT Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. the Diabetes Control and Complications Trial research group. N. Engl. J. Med. 329(14), 977-986 (1993).
21. Nathan DM, Cleary PA, Backlund JY et al. Intensive diabetes treatment and cardiovascular disease in patients with Type 1 diabetes. N. Engl. J. Med. 353(25), 2643-2653 (2005).
22. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with Type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) group. Lancet 352(9131), 837-853 (1998).
23. Stratton IM, Adler AI, Neil HA et al. Association of glycaemia with macrovascular and microvascular complications of Type 2 diabetes (UKPDS 35), prospective observational study. BMJ 321(7258), 405-412 (2000).
24. Singer DE, Coley CM, Samet JH, Nathan DM. Tests of glycemia in diabetes mellitus. Their use in establishing a diagnosis and in treatment. Ann. Intern. Med. 110(2), 125-137 (1989).
25. Nathan DM, Singer DE, Hurxthal K, Goodson JD. The clinical information value of the glycosylated hemoglobin assay N. Engl. J. Med. 310(6), 341-346 (1984).
26. Tahara Y, Shima K. Kinetics of HbA1c, glycated albumin, and fructosamine and analysis of their weight functions against preceding plasma glucose level. Diabetes Care 18(4), 440-447 (1995).
27. Weber C, Schnell O. The assessment of glycemic variability and its impact on diabetes-related complications: an overview. Diabetes Technol. Ther. 11(10), 623-633 (2009).
28. Weinstein MC, Toy EL, Sandberg EA et al. Modeling for health care and other policy decisions: uses, roles, and validity Value Health 4(5), 348-361 (2001). • Excellent introduction in the role of disease modeling for those not familiarized with the topic.
29. American Diabetes Association Consensus Panel. Guidelines for computer modeling of diabetes and its complications. Diabetes Care 27(9), 2262-2265 (2004).
30. Weinstein MC. A Report of the ISPOR Health Science Committee - Task Force on Good Research Practices - Modeling Studies. (2005).
31. Mount Hood 4 Modeling Group. Computer modeling of diabetes and its complications: a report on the Fourth Mount Hood Challenge Meeting. Diabetes Care 30(6), 1638-1646 (2007).
32. Broome J. Trying to value a life. J. Pub. Econ. 9, 91-100 (1982).
33. Karlsson G, Johannesson M. The decision rules of cost-effectiveness analysis. Pharmacoeconomics 9(2), 113-120 (1996).
34. Garber AM, Phelps CE. Economic foundations of cost-effectiveness analysis. J. Health Econ. 16(1), 1 (1997). •• Recommended (despite the year of publication) as further reading for those wishing to delve into the economic basics of cost-effectiveness analysis; requires some mathematical understanding.
35. Olsen JA. Theories of justice and their implications for priority setting in health care. J. Health Econ. 16(6), 625-639 (1997). •• Excellent overview on theories of distributive justice; recommended for further reading for those interested in aspects of welfare economics.
36. Weinstein M, Zeckhauser R. Critical ratios and efficient allocation. J. Pub. Econ. 2, 147-157 (1973).
37. Birch S, Gafni A. Information created to evade reality (ICER): things we should not look to for answers. Pharmacoeconomics 24(11), 1121-1131 (2006). • Excellent description of the difficulties related to the use of incremental cost-effectiveness ratios.
38. Birch S, Gafni A. The biggest bang for the buck or bigger bucks for the bang: the fallacy of the cost-effectiveness threshold. J. Health Serv. Res. Policy 11(1), 46-51 (2006).
39. Trueman P, Drummond M, Hutton J. Developing guidance for budget impact analysis. Pharmacoeconomics 19(6), 609-621 (2001).
40. Nuijten MJ, Rutten F. Combining a budgetary-impact analysis and a costeffectiveness analysis using decisionanalytic modelling techniques. Pharmacoeconomics 20(12), 855-867 (2002).
41. Orlewska E, Mierzejewski P. Proposal of Polish guidelines for conducting financial analysis and their comparison to existing guidance on budget impact in other countries. Value Health 7(1), 1-10 (2004).
42. Mauskopf JA, Earnshaw S, Mullins CD. Budget impact analysis: review of the state of the art. Expert Rev. Pharmacoeconomics Outcomes Res. 5(1), 65-79 (2005). • Recommended as further reading for those not familiarized with the principles of budget-impact analysis.
43. Sendi PP, Briggs AH. Affordability and cost-effectiveness: decision-making on the cost-effectiveness plane. Health Econ. 10(7), 675-680 (2001).
44. Hirth RA, Chernew ME, Miller E et al. Willingness to pay for a quality-adjusted life year: in search of a standard. Med. Decis. Making 20(3), 332-342 (2000).
45. Kaplan R, Bush J. Health related quality of life measurement for evaluation research and policy analysis. Health Psychol. 1, 61-80 (1982).
46. Laupacis A, Feeny D, Detsky AS, Tugwell PX. How attractive does a new technology have to be to warrant adoption and utilization? Tentative guidelines for using clinical and economic evaluations. CMAJ 146(4), 473-481 (1992).
47. Stevens A, Colin-Jones D, Gabbay J. 'Quick and clean': authoritative health technology assessment for local health care contracting. Health Trends 27(2), 37-42 (1995).
48. Devlin N, Parkin D. Does NICE have a cost-effectiveness threshold and what other factors influence its decisions? A binary choice analysis. Health Econ. 13(5), 437-452 (2004).
49. George B, Harris A, Mitchell A. Cost-effectiveness analysis and the consistency of decision making: evidence from pharmaceutical reimbursement in Australia (1991 to 1996). Pharmacoeconomics 19(11), 1103-1109 (2001).
50. Council for Public Health and Health Care. Sensible and Sustainable Care. Recommendations by the Council for Public Health and Health Care to the Minister of Health, Wefare and Sports (2006).
51. Dardis R. The value of life: new evidence from the marketplace. Am. Econ. Rev. 70(5), 1077-1082 (1980).
52. Ippolito P, Ippolito R. Measuring the value of live saving from consumer reactions to new information. J. Pub. Econ. 25, 53-81 (1984).
53. Lanoie P, Pedro C, Latour R. The value of a statistical life: a comparision of two approaches. J. Risk Uncertain. 10, 235-257 (1995).
54. Miller T. Variations between countries in values of statistical life. J. Transport Econ. Pol. 34(2), 169-188 (2000).
55. Mrozek J, Taylor L. What determines the value of life? A meta-analysis. J. Pol. Anal. Manage. 21(2), 253-270 (2002).
56. Tengs T, Adams M, Pliskin J et al. Five-hundred life-saving interventions and their cost-effectiveness. Risk Anal. 15(3), 369-390 (1995).
57. Viscusi W, Aldy J. The Value of a Statistical Life: a Critical Review of Market Estimates Throughout the World. NBER Working Paper 9487, MA, USA (2003). • A good starting point for those interested in the principles of the 'value of a statistical life' concept.
58. The World Bank. World Development Report. The World Bank, Washington, DC, USA (1993).
59. Anand S, Hanson K. Disability-adjusted life years: a critical review. J. Health Econ. 16(6), 685-702 (1997).
60. Arnesen T, Nord E. The value of DALY life: problems with ethics and validity of disability adjusted life years. BMJ 319(7222), 1423-1425 (1999).
61. Drummond M, Torrance G, Mason J. Cost-effectiveness league tables: more harm than good? Soc. Sci. Med. 37(1), 33-40 (1993).
62. Sach TH, Smith RD, Whynes DK. A 'league table' of contingent valuation results for pharmaceutical interventions: a hard pill to swallow? Pharmacoeconomics 25(2), 107-127 (2007).
63. Luce BR, Mauskopf J, Sloan FA et al. The return on investment in health care: from 1980 to 2000. Value Health 9(3), 146-156 (2006).
64. Mc Kee M, Nolte E, Suhrcke M. The Value of Health Improvements in the European Union. London School of Hygiene and Tropical Medicine, London, UK (2005).
65. Nordhaus W, Tobin J. Is Growth Obsolete? Columbia University Press, NY, USA (1972).
66. Daly HE, Cobb J. For the Common Good. Redirecting the Economy Toward Community, the Environment and a Sustainable Future. Beacon Press, MA, USA (1994).
67. Ul Haq M. Reflections on Human Development. Oxford University Press, NY, USA (1995).
68. King JT, Tsevat J, Lave JR, Roberts MS. Willingness to pay for a quality-adjusted life year: implications for societal health care resource allocation. Med. Decis. Making 25(6), 667-677 (2005).
69. Guria J, Leung J, Jones-Lee M, Loomes G. The willingness to accept value of statistical life relative to the willingness to pay value: evidence and policy implications. Environmental Res. Econ. 32(1), 113-127 (2005).
70. Smith RD, Richardson J. Can we estimate the 'social' value of a QALY? Four core issues to resolve. Health Policy 74(1), 77-84 (2005).
71. Gyrd-Hansen D. Willingness to pay for a QALY: theoretical and methodological issues. Pharmacoeconomics 23(5), 423-432 (2005).
72. Richardson J, Smith RD. Calculating society's willingness to pay for a QALY: key questions for discussion. Appl. Health Econ. Health Policy 3(3), 125-116 (2004).
73. Philipson T, Becker G, Goldman D, Murphy K. Terminal care and the value of life near its end. The Milton Friedman Institute For Research in Economics, Report No.: MFI Working Paper Series Chicago, IL, USA (2010).
74. Gafni A, Birch S. Guidelines for the adoption of new technologies: a prescription for uncontrolled growth in expenditures and how to avoid the problem. CMAJ 148(6), 913-917 (1993).
75. Gafni A, Birch S. Inclusion of drugs in provincial drug benefit programs: should 'reasonable decisions' lead to uncontrolled growth in expenditures? CMAJ 168(7), 849-851 (2003).
76. Suhrcke M, Mc Kee M, Sauto-Arce R et al. The Contribution of Health to the Economy in the European Union. Office for Pfficial Publications of the European Communities Luxembourg (2005).
77. Nordhaus W. The health of nations: the contribution of improved health to living standards. In: The Measurement of Economic and Social Performance. Moss M (Eds). Columbia University Press for National Bureau of Economic Research, NY, USA (2003).
78. Shillcutt S, Walker D, Goodman C, Mills A. Cost effectiveness in low-and middle-income countries. A review of the debates surrounding decision rules. Pharmacoeceonomics 27(11), 903-917 (2009).
79. Ham C. Retracing the Oregon trail: the experience of rationing and the Oregon health plan. BMJ 316(7149), 1965-1969 (1998).
80. Blumstein JF. The Oregon experiment: the role of cost-benefit analysis in the allocation of Medicaid funds. Soc. Sci. Med. 45(4), 545-554 (1997).
81. Dolan P, Metcalfe R, Munro V, Christensen M. Valuing lives and life years: anomalies, implications, and an alternative. Health Econ. Pol. Law 3, 277-300 (2008).
82. Fox-Rushby JA, Hanson K. Calculating and presenting disability adjusted life years (DALYs) in cost-effectiveness analysis. Health Policy Plan 16(3), 326-331 (2001).
83. Willke RJ, Glick HA, Polsky D, Schulman K. Estimating country-specific cost-effectiveness from multinational clinical trials. Health Econ. 7(6), 481-493 (1998).
84. Cook JR, Drummond M, Glick H, Heyse JF. Assessing the appropriateness of combining economic data from multinational clinical trials. Stat. Med. 22(12), 1955-1976 (2003).
85. Pinto EM, Willan AR, O'Brien BJ. Cost-effectiveness analysis for multinational clinical trials. Stat. Med. 24(13), 1965-1982 (2005).
86. Manca A, Willan A. Lost in translation: accounting for between-country differences in the analysis of multinational cost-effectiveness data. Pharmacoeconomics 24(11), 1101-1119 (2006).
87. Willan AR, Pinto EM, O'Brien BJ et al. Country specific cost comparisons from multinational clinical trials using empirical Bayesian shrinkage estimation: the Canadian ASSENT-3 economic analysis. Health Econ. 14(4), 327-338 (2005).
88. Manca A, Rice N, Sculpher MJ, Briggs AH. Assessing generalisability by location in trial-based cost-effectiveness analysis: the use of multilevel models. Health Econ. 14(5), 471-485 (2005).
89. Hopkins S, Varjonen S. Development of Health-Specific Purchasing Power Parities: General Principles and Problems in Measurement of Health Services Across Countries. OECD Report No.: DELSA/HEA/HA/PPP (2007).