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The validity of cost-effectiveness analyses of tight glycemic control. A systematic survey of economic evaluations of pharmacological interventions in patients with type 2 diabetes

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dc.contributor.author Barrera, Francisco J.
dc.contributor.author Toloza, Freddy
dc.contributor.author Ponce, Oscar J.
dc.contributor.author Zuñiga Hernández, Jorge A.
dc.contributor.author Prokop, Larry J.
dc.contributor.author Shah, Nilay D.
dc.contributor.author Guyatt, Gordon
dc.contributor.author Rodríguez Gutierrez, Rene
dc.contributor.author Montori, Victor M.
dc.date.accessioned 2021-04-13T20:50:59Z
dc.date.available 2021-04-13T20:50:59Z
dc.date.issued 2020
dc.identifier.uri https://hdl.handle.net/20.500.12866/9133
dc.description.abstract PURPOSE: Currently available randomized trial evidence has shown no reductions in type 2 diabetes (T2D) complications important to patients with tight glycemic control. Yet, economic analyses consistently find tight glycemic control to be cost-effective. To understand this apparent paradox, we systematically identified and appraised economic analyses of tight glycemic control for T2D. METHODS: We searched multiple databases from January 2016 to January 2018 for cost-effectiveness or cost-utility analyses of any glucose-lowering treatments for adults with T2D using simulations with long-40 years to lifetime-time horizons. Reviewers selected and appraised each study independently and in duplicate with good reproducibility. RESULTS: We found 30 analyses, most comparing the glycemic impact of glucose-lowering drugs and applying their impact on HbA1c to model (most commonly IMS CORE or Cardiff T2DM) their impact on the incidence of diabetes-related complication. Models drew from observational evidence of the correlation of HbA1c levels and diabetes-related complication rates; none used estimates of the effect of lowering HbA1c on these outcomes from systematic reviews of randomized trials. Sensitivity analyses, when conducted, demonstrate substantial loss of cost-effectiveness as simulations approach the results seen in these trials. CONCLUSIONS: Reliance on the association between glycemic control and diabetes-related complications evident in observational studies but not apparent in randomized trial bias the estimates of the cost-effectiveness of interventions to improve glycemic control. en_US
dc.language.iso eng
dc.publisher Springer
dc.relation.ispartofseries Endocrine
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Article en_US
dc.subject human en_US
dc.subject priority journal en_US
dc.subject cardiovascular risk en_US
dc.subject non insulin dependent diabetes mellitus en_US
dc.subject systematic review en_US
dc.subject Type 2 diabetes en_US
dc.subject hemoglobin A1c en_US
dc.subject hemoglobin blood level en_US
dc.subject acarbose en_US
dc.subject albiglutide en_US
dc.subject alogliptin en_US
dc.subject antidiabetic agent en_US
dc.subject canagliflozin en_US
dc.subject continuous infusion en_US
dc.subject cost effectiveness analysis en_US
dc.subject Cost effectiveness analysis en_US
dc.subject cost utility analysis en_US
dc.subject dapagliflozin en_US
dc.subject dipeptidyl peptidase IV inhibitor en_US
dc.subject drug cost en_US
dc.subject dulaglutide en_US
dc.subject economic evaluation en_US
dc.subject Economic evaluation en_US
dc.subject exendin 4 en_US
dc.subject glimepiride en_US
dc.subject glycemic control en_US
dc.subject Health economics en_US
dc.subject Health policy en_US
dc.subject insulin en_US
dc.subject insulin aspart en_US
dc.subject insulin degludec plus liraglutide en_US
dc.subject insulin detemir en_US
dc.subject insulin glargine en_US
dc.subject insulin lispro en_US
dc.subject Intensive glycemic control en_US
dc.subject isophane insulin en_US
dc.subject liraglutide en_US
dc.subject lixisenatide en_US
dc.subject metformin en_US
dc.subject reproducibility en_US
dc.subject saxagliptin en_US
dc.subject sitagliptin en_US
dc.subject sulfonylurea en_US
dc.subject vildagliptin en_US
dc.title The validity of cost-effectiveness analyses of tight glycemic control. A systematic survey of economic evaluations of pharmacological interventions in patients with type 2 diabetes en_US
dc.type info:eu-repo/semantics/review
dc.identifier.doi https://doi.org/10.1007/s12020-020-02489-w
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.18
dc.relation.issn 1559-0100


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