Economic evaluation of continuous subcutaneous insulin infusion for children with diabetes - a pilot study: CSII application for children - economic evaluation.
BACKGROUND
The objective of this study is to assess the cost of using continuous subcutaneous insulin infusion to treat children with type-1diabetes in Bulgaria, considering changes in body mass index (BMI) and the glycated hemoglobin. The study was performed from the perspective of the Bulgarian National Health Insurance Fund (NHIF) and patients.


METHODS
A total of 34 pediatric type-1-diabetes patients were observed for 7 months, divided into 2 groups - on pumps and on insulin analogue therapy. Patient demographic data, BMI and glycated hemoglobin level were obtained and recorded. The cost of insulin, pumps, and consumables were calculated and compared with changes in glycated hemoglobin level. The incremental cost-effectiveness ratio was below the threshold value of gross domestic product per capita.


RESULTS
The results were sensitive to changes in glycated hemoglobin level. Improvements associated with glycemic control led to a reduced glycated hemoglobin level that could ensure good diabetes management, but its influence on BMI in growing children remains unclear.


CONCLUSIONS
Continuous subcutaneous insulin infusion appears to be more cost-effective for the Bulgarian pediatric population and health care system.
Department of Social Pharmacy, Medical University Sofia, Faculty of Pharmacy, Sofia, Bulgaria. petkovav1972@yahoo.com.
Elina
E
Petkova
Valentina
V
Petkova
Maia
M
Konstantinova
Guenka
G
Petrova
D000293:Adolescent; D015992:Body Mass Index; D002031:Bulgaria; D002648:Child; D003362:Cost-Benefit Analysis / Q000706:statistics & numerical data; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D016503:Drug Delivery Systems / Q000191:economics*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000191:economics; D055104:Infusions, Subcutaneous / Q000191:economics* / Q000379:methods; D007328:Insulin / Q000008:administration & dosage* / Q000191:economics; D008297:Male; D010865:Pilot Projects
D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin