title: Life prolonging of disease management programs in patients with type 2 diabetes is cost-effective.
abstract: OBJECTIVE
  Our objective was to examine the cost-effectiveness of disease management programs (DMPs) for type 2 diabetes mellitus (T2DM) taking into account their life prolonging effect.
  
  
  METHODS
  We compared real life costs in 19,888 propensity score matched pairs of T2DM DMP participants and T2DM patients in routine care (RC) according to sickness funds data. We estimated mean annual costs for survivors, last year of life costs for decedents, the influence of ageing on costs, incremental cost-effectiveness ratio and effects on hospitalization.
  
  
  RESULTS
  Annual costs for survivors were 3,318€ (DMP) and 3,570€ (RC). The mean costs in the last year of life were 16,911€ (DMP) and 15,763€ (RC). Ageing had a cost triggering effect for survivors (30€/36€ per year in DMP-/RC-group; p<0.001) and a cost decreasing effect in the last year of life (546€/483€ per year in DMP-/RC-group; p<0.001). The incremental cost-effectiveness ratio of the DMP vs. RC was -1396€ per life-year gained. Hospitalizations increased with age in case of survival and decreased with age in case of death but were always lower in the DMP-group.
  
  
  CONCLUSIONS
  Despite increase in costs due to longer life DMPs are cost-effective.
authors: Institute of Health Economics and Clinical Epidemiology, University Hospital Cologne, Gleueler Straße 176-178, 50935 Köln, Germany. anna.drabik@gmx.de
authors: A
authors: A
authors: Drabik
authors: G
authors: G
authors: Büscher
authors: P T
authors: PT
authors: Sawicki
authors: K
authors: K
authors: Thomas
authors: C
authors: C
authors: Graf
authors: D
authors: D
authors: Müller
authors: S
authors: S
authors: Stock
mesh_terms: D000368:Aged; D000375:Aging; D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008297:Male; D015397:Program Evaluation