- 期刊
Economic Analysis of a Diabetes-Specific Nutritional Meal Replacement for Patients with Type 2 Diabetes
糖尿病专用营养配方的經濟效益分析
摘要
本文透过比较结构性干预管理方案与常规治疗方案对糖尿病患者10年治疗效果与医疗费用的差别，研究一种糖尿病患专用营养配方对糖尿病营养治疗的效用。利用现有的临床试验数据，我们研发了一个计算机模擬程式以追踪糖尿病患者微血管和大血管的健康状况、累计医疗费用和生活质量调整的生命年限。这一模擬程式能够建立及比较各种生活方式。当糖尿病专用营养配方的使用是实验组与对照组的唯一差别，在其他开支相同的情况下，糖尿病专用营养配方干预措施成本更低，比常规治疗更加有效。当其作为额外的代餐，根据糖化血红蛋白的改善情况，糖尿病专用营养配方能增加成本效益比50,414到55,036美元。假如将糖尿病专用营养配方用于糖尿病结构性干预管理方案中，则能提高成本效益比47,917美元。综上所述，本研究发现使用糖尿病专用营养配方在各种模擬的方式下皆能提高成本效益。
並列摘要
This study extends nutritional intervention results reported by short-term clinical trials of a diabetes-specific nutritional meal replacement by assessing the ten-year impact of the interventions on patient outcomes and costs compared to usual care. We developed and validated a computer simulation of type 2 diabetes based on published data from major clinical trials. The model tracks patients through microvascular and macrovascular health states and reports cumulative costs and quality adjusted life years. We modeled different scenarios that include a diabetes-specific nutritional meal replacement as part of a structured lifestyle intervention, and also as the only difference between the intervention and usual care treatment groups, and compared them to usual care with diet and physical activity recommendations. We used sensitivity analysis to explore the robustness of results. When a diabetes-specific nutritional meal replacement is the only treatment difference and is considered an equal cost meal replacement, the diabetes-specific nutritional meal replacement interventions are less costly and more effective than usual care. As an added cost meal replacement, the diabetes-specific nutritional meal replacement has an incremental cost-effectiveness ratio between $50,414 and $55,036 depending on improvement in percent glycated hemoglobin. A hypothetical lifestyle intervention using a diabetes-specific nutritional meal replacement has an incremental cost-effectiveness ratio of $47,917. The diabetes-specific nutritional meal replacement was found to be cost-effective under the various conditions simulated.
延伸閱讀
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