Economic evaluation of alternative strategies to treat patients with diabetes mellitus and coronary artery disease.
Diabetes mellitus and coronary artery disease (CAD) commonly coexist, and thus effective, cost-effective management strategies are needed. Intensive management of diabetes has been shown to increase medical costs while yielding better outcomes, with an acceptable cost-effectiveness ratio of <50,000 dollars per life-year added. On the basis of clinical trial findings in the 1970s and 1980s, coronary bypass surgery was cost-effective compared with medical therapy in the treatment of extensive CAD. Few trials have compared angioplasty with medical therapy, and its cost-effectiveness is not well established. The economic outcomes of contemporary coronary revascularization, especially angioplasty, compared with contemporary medical therapy must be evaluated. The Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial will collect extensive economic data and examine the cost-effectiveness of alternative strategies to manage diabetes and CAD in patients with both disorders.
Hlatky
Mark A
MA
Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California 94305-5405, USA. hlatky@stanford.edu
Melsop
Kathryn A
KA
Boothroyd
Derek B
DB
D015906:Angioplasty, Balloon, Coronary / Q000191:economics; D001026:Coronary Artery Bypass / Q000191:economics; D003324:Coronary Artery Disease / Q000150:complications / Q000191:economics / Q000628:therapy*; D003362:Cost-Benefit Analysis; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000191:economics / Q000628:therapy*; D006801:Humans; D007004:Hypoglycemic Agents / Q000191:economics; D009204:Myocardial Revascularization / Q000191:economics; D016032:Randomized Controlled Trials as Topic; D014481:United States
D007004:Hypoglycemic Agents