Cost effectiveness of an intensive blood glucose control policy in patients with type 2 diabetes: economic analysis alongside randomised controlled trial (UKPDS 41). United Kingdom Prospective Diabetes Study Group.
OBJECTIVE
To estimate the cost effectiveness of conventional versus intensive blood glucose control in patients with type 2 diabetes.


METHODS
Incremental cost effectiveness analysis alongside randomised controlled trial.


METHODS
23 UK hospital clinic based study centres.


METHODS
3867 patients with newly diagnosed type 2 diabetes (mean age 53 years).


METHODS
Conventional (primarily diet) glucose control policy versus intensive control policy with a sulphonylurea or insulin.


METHODS
Incremental cost per event-free year gained within the trial period.


RESULTS
Intensive glucose control increased trial treatment costs by pound 695 (95% confidence interval pound 555 to pound 836) per patient but reduced the cost of complications by pound 957 (pound 233 to pound 1681) compared with conventional management. If standard practice visit patterns were assumed rather than trial conditions, the incremental cost of intensive management was pound 478 (-pound 275 to pound 1232) per patient. The within trial event-free time gained in the intensive group was 0.60 (0.12 to 1.10) years and the lifetime gain 1.14 (0.69 to 1.61) years. The incremental cost per event-free year gained was pound 1166 (costs and effects discounted at 6% a year) and pound 563 (costs discounted at 6% a year and effects not discounted).


CONCLUSIONS
Intensive blood glucose control in patients with type 2 diabetes significantly increased treatment costs but substantially reduced the cost of complications and increased the time free of complications.
Gray
A
A
Health Economics Research Centre, Department of Public Health, University of Oxford, Institute of Health Sciences, Headington OX3 7LF. alistair.gray@ihs.ox.ac.uk
Raikou
M
M
McGuire
A
A
Fenn
P
P
Stevens
R
R
Cull
C
C
Stratton
I
I
Adler
A
A
Holman
R
R
Turner
R
R
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D015190:Blood Glucose Self-Monitoring / Q000191:economics*; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D003928:Diabetic Nephropathies / Q000191:economics; D003930:Diabetic Retinopathy / Q000191:economics; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008875:Middle Aged
D001786:Blood Glucose