[Assessment of the budgetary impact of treatment guidelines in type II diabetes mellitus in France].
BACKGROUND
Type II diabetes mellitus is associated with an increasing prevalence and incidence, and with a heavy economic burden in Western countries. As a consequence, health authorities consider that avoidance or delay of occurrence of diabetes-related micro- and macro-angiopathic complications is a public health priority, leading to the definition of treatment guidelines. The aim of the study was to assess the budgetary impact of the application of the French guidelines.


METHODS
Etiologic cost ratios.


RESULTS
Our results conclude that 10% decrease in body mass index (BMI) among overweight patients, smoking cessation, initiation to undertake a preventive treatment with low-dose aspirin, initiation to undertake or intensify blood pressure control, initiation to undertake or intensify lipidic control, and shift to biguanides among overweight patients are factors associated with significant benefits (avoided costs) which compensate for the increase in treatment costs. The main beneficial strategies are, in decreasing order, initiation to undertake a preventive treatment with low-dose aspirin, smoking cessation, and control of BMI.


CONCLUSIONS
Our results support interest in reinforcing the application of current treatment guidelines for type II diabetes mellitus.
Marissal
J-P
JP
CRESGE-LABORES (URA-CNRS 362), Université Catholique de Lille, 1, rue Norbert-Segard, BP 109, 59016 Lille Cedex. contact@cresge.fr
Sailly
J-C
JC
Crainich
D
D
Lebrun
T
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D001241:Aspirin / Q000627:therapeutic use; D001645:Biguanides / Q000627:therapeutic use; D002561:Cerebrovascular Disorders / Q000191:economics / Q000209:etiology; D003327:Coronary Disease / Q000191:economics / Q000209:etiology; D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000191:economics* / Q000628:therapy*; D003925:Diabetic Angiopathies / Q000191:economics / Q000209:etiology; D004359:Drug Therapy, Combination; D005602:France; D019983:Guideline Adherence; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000191:economics / Q000209:etiology; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care; D016540:Smoking Cessation
D001645:Biguanides; D010975:Platelet Aggregation Inhibitors; D001241:Aspirin