BIOM30001 Lecture Notes - Lecture 11: Blood Sugar, Cardiovascular Disease, Glycated Hemoglobin
Types of economic evaluation:
Don't tend to do cost benefit analysis in health (don't give everything a dollar value)
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Tend to do cost-effectiveness analysis
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CEA example
Intervention involved use of blood pressure drugs in diabetes
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Intervention cost $1350 (over four years)
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Intervention group experienced lower hospital and other health care costs ~$800 in savings
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Net cost was around $502
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Increase in life expectancy 0.05 life years over remaining lifetimes
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Cost-effectiveness of lowering blood pressure with a fixed combination of perindopril and
indapamide in type 2 diabetes mellitus: an ADVANCE trial-based analysis (Glasziou, Clarke, Alexander
et al)
Cost-effectiveness plane
Control in the middle
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NE quadrant: increase in outcome = increase in costs (most technologies operate in this
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11: Pharmacoeconomics of Type 2 Diabetes Treatments
Sunday, August 16, 2015
1:40 PM
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NE quadrant: increase in outcome = increase in costs (most technologies operate in this
quadrant)
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NW quadrant: intervention is more costly but less effective (decreases life years) therefore
would not invest in this drug
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SW quadrant: cheaper but less effective (Aus doesn't operate like this)
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SE quadrant: more effective and cheaper - no tradeoff
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Using QALYs to measure health gain
QALY: quality adjusted life year (quality of life). Given by the area between the curves
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Clinical trials often use 'Time to first event' as a measure; can also use life expectancy, number
of serious events that occur
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How Simulation Models Work
Need models to give a profile of benefits and costs
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In chronic diseases like diabetes it takes time (sometimes more than a decade) for treatments
to work. So need simulation
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There are many different types of diabetes-related complications (including cardiovascular
disease, eye and kidney disease)
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Many different factors influence the risk of developing complications (HbA1c (hemaglobin);
blood pressure; measures of kidney function)
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Helps you answer 'what ifs', based on a synthesis of available data
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Why do we need complex diabetes simulation models?
Health economists have been developing simulation models since the Eastman Model of the
mid-1990
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Need simulation models to evaluate the impact of interventions on the progression of the
disease
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Many diabetes simulation models have been developed, but tend to have common origins
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History of diabetes simulation models
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Document Summary
Don"t tend to do cost benefit analysis in health (don"t give everything a dollar value) Cost-effectiveness of lowering blood pressure with a fixed combination of perindopril and indapamide in type 2 diabetes mellitus: an advance trial-based analysis (glasziou, clarke, alexander et al) Intervention involved use of blood pressure drugs in diabetes. Intervention group experienced lower hospital and other health care costs ~ in savings. Increase in life expectancy 0. 05 life years over remaining lifetimes. Ne quadrant: increase in outcome = increase in costs (most technologies operate in this. Ne quadrant: increase in outcome = increase in costs (most technologies operate in this quadrant) Nw quadrant: intervention is more costly but less effective (decreases life years) therefore would not invest in this drug. Sw quadrant: cheaper but less effective (aus doesn"t operate like this) Se quadrant: more effective and cheaper - no tradeoff. Qaly: quality adjusted life year (quality of life).
