title: The cost-effectiveness analysis of JinQi Jiangtang tablets for the treatment on prediabetes: a randomized, double-blind, placebo-controlled, multicenter design.
abstract: BACKGROUND
  At present, diabetes is a chronic disease of great cost and heavy burdens. The International Diabetes Federation has repeatedly warned that by 2025, the global number of diabetics would rise to 333 million from 194 million in 2003. Although the occurrence of diabetes in developing countries is lower, China has a large population, so that the number of cases is increased. At the same time, more people have prediabetes, a growing health concern where a large percentage of the patients develop full type 2 diabetes. In addition, the patients of diabetes easily incur complications such as blindness, kidney failure, and cardiovascular diseases that can seriously affect the patients' quality of life and cause great economic burdens to family and society. Therefore, effective interventions for prediabetes are needed to prevent or delay the occurrence and development of diabetes.
  
  
  METHODS
  A randomized controlled trial that was assessed with pharmacoeconomic methods was undertaken in this study. The study term was 24 months (12 months for the intervention and 12 months for follow up). Four hundred participants, recruited from four cities in China: Beijing, Tianjin, Xian, and Naning, were randomized to the treatment group (JQJT tablets) and the control group (placebo). Participants included in this study had been diagnosed with prediabetes according to the criteria for western medicine and Traditional Chinese Medicine (TCM). The end-point effectiveness indexes included the incidence of diabetes and the reversion rate. The drug costs and lifestyle intervention costs were included in the total costs. The study used the cost-effectiveness analysis to discuss the economic advantage of the JQJT tablets.
  
  
  RESULTS
  The outcomes of the study contained 2 sections,namely clinical outcomes and cost-effectiveness analysis outcomes. The clinical outcomes: the treatment group and control group had no significant statistical difference P> 0.05) on the baseline of situation; Jinqi Jiangtang tablet effectively reduced the incidence of diabetes mellitus and enhanced reversion rate. compared with the control group (p< 0.05); the scores of SF-36 of two groups had no significant difference P> 0.05); finally the compliance of participants between the two groups had no significant difference. The cost-effectiveness analysis outcomes:in the intervention period of 12 months,on the aspect of reversion rate, the treatment group had better economic advantage by using cost-effectiveness ratio and the incremental cost-effectiveness ratio;on the aspect of the incidence of diabetes, the control group had better economic advantage by using cost-effectiveness ratio and the incremental cost-effectiveness ratio; in the follow-up period of 24 months, on the aspect of reversion rate, the treatment group had better economic advantage by using cost-effectiveness ratio and the incremental cost-effectiveness ratio, on the aspect of the incidence of diabetes, the control group had better economic advantage by using cost-effectivenes ratio and the incremental cost-effectiveness ratio.At the same time, these outcomes remained the same by sensitivity analysis. Assuming that prices and resident incomes rose 5%, the sensitiveness analysis shows that the two group affected by the paremeters changed little.
  
  
  CONCLUSIONS
  The importance and effectiveness of lifestyle education and JinQi Jiangtang tablets was proven. In both the intervention period and follow-up, JinQi Jiangtang tablets combined with lifestyle education had a greater cost advantage effect than the lifestyle education alone on the reversion rate; the lifestyle education had a greater cost advantage effect than the JinQi Jiangtang tablets combined with lifestyle education on the incidence of diabetes.
  
  
  BACKGROUND
  Chinese Clinical Trials ChiCTR-TRC-09000401 ) , registered on 25 May 2009.
authors.affiliation: Tianjin University of TCM, 9 ShuangfengStreet, Nankai District, Tianjin, 300193, China. s.x.1988@163.com.
authors.forename: Xiao
authors.initials: X
authors.lastname: Sun
authors.affiliation: Baokang Hospital of Tianjin University of TCM, Tianjin, China. lpgtjn@163.com.
authors.forename: Liping
authors.initials: L
authors.lastname: Guo
authors.affiliation: Dingzhi Men Hospital of Beijing University of TCM, Tianjin, China. shanghongcai@foxmail.com.
authors.forename: Hongcai
authors.initials: H
authors.lastname: Shang
authors.affiliation: Baokang Hospital of Tianjin University of TCM, Tianjin, China. renming2008@126.com.
authors.forename: Ming
authors.initials: M
authors.lastname: Ren
authors.affiliation: Inner Mongolia Autonomous Region People's hospital, Tianjin, China. 359592107@qq.com.
authors.forename: Yue
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Tianjin University of TCM Affiliated Wuqing Hospital of TCM, Tianjin, China. 842716728@qq.com.
authors.forename: Da
authors.initials: D
authors.lastname: Huo
authors.affiliation: Tianjin University of TCM, 9 ShuangfengStreet, Nankai District, Tianjin, 300193, China. 864177543@qq.com.
authors.forename: Xiang
authors.initials: X
authors.lastname: Lei
authors.affiliation: Tianjin Institute of Clinical Evaluation, Tianjin University of TCM, 88 YuquanStreet, Nankai District, Tianjin, 300193, China. wanghui1983@foxmail.com.
authors.forename: Hui
authors.initials: H
authors.lastname: Wang
authors.affiliation: Tianjin Institute of Clinical Evaluation, Tianjin University of TCM, 88 YuquanStreet, Nankai District, Tianjin, 300193, China. 936669273@qq.com.
authors.forename: Jingbo
authors.initials: J
authors.lastname: Zhai
mesh_terms: D000284:Administration, Oral; D001786:Blood Glucose / Q000187:drug effects* / Q000378:metabolism; D002681:China / Q000453:epidemiology; D003131:Combined Modality Therapy; D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control*; D018450:Disease Progression; D004311:Double-Blind Method; D016527:Drug Costs; D004365:Drugs, Chinese Herbal / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000191:economics; D011236:Prediabetic State / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics* / Q000453:epidemiology; D040242:Risk Reduction Behavior; D013607:Tablets; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D004365:Drugs, Chinese Herbal; D007004:Hypoglycemic Agents; D013607:Tablets; C527173:jinqi jiantang