Modeling the economic impact of medication adherence in type 2 diabetes: a theoretical approach

summary of modeled results: iDM vs OADs * IDM vs OADs IDM OADs DifferenceAnalysis 1 Clinical outcomes, years Life expectancy (discounted) 16.376 (0.18) 15.815 (0.17) 0.561 (0.01) Quality-adjusted life expectancy 10.554 (0.10) 9.631 (0.09) 0.923 (0.01)Complication rates, cumulative incidence, % (sD) end-stage renal disease 17.6 (1.1) 18.1 (1.2) -0.5 (0.1) Amputation 13.4 (1.1) 13.8 (1.0) -0.4 (0.1) CVD/CAD 22.1 (1.3) 22.7 (1.5) -0.6 (0.2) nephropathy 36.3 (1.6) 37.2 (1.6) -0.9 (0.0) stroke 9.1 (0.9) 9.4 (1.0) -0.3 (0.1) neuropathy 46.3 (1.6) 47.8 (1.5) -1.5 (0.1) retinopathy 19.9 (1.3) 19.8 (1.3) 0.1 (0.0) Major hypoglycemia 63.8 (1.9) 55.5 (1.8) 8.3 (0.1)Cost outcomes, Us$ Direct medical costs 241,304 (8122) 238,906 (8218) 2,398 (96) Pharmacy costs 60,551 (2231) 51,783 (2004) 8,768 (227) Total lifetime costs 301,855 (8933) 290,689 (8690) 11,166 (243)$/QALY (iDM vs OADs) 12,097 Analysis 2 Clinical outcomes, years Life expectancy (discounted) 16.562 (0.18) 16.231 (0.17) 0.331 (0.01) Quality-adjusted life expectancy 10.848 (0.10) 10.173 (0.01) 0.675 (0.09)Complication rates, cumulative incidence, % (sD) end-stage renal disease 17.0 (1.1) 17.3 (1.0) -0.3 (0.1) Amputation 13.3 (1.0) 13.6 (1.2) -0.3 (0.2) CVD/CAD 21.9 (1.4) 22.1 (1.3) -0.2 (0.1) nephropathy 34.7 (1.4) 35.0 (1.4) -0.3 (0.0) stroke 8.8 (0.8) 8.9 (0.8) -0.1 (0.0) neuropathy 45.8 (1.7) 46.6 (1.7) -0.8 (0.0) retinopathy 18.5 (1.2) 18.2 (1.1) 0.3 (0.1) Major hypoglycemia 59.8 (1.8) 48.4 (1.6) 11.4 (0.2)Cost outcomes, Us$ Direct medical costs 244,112 (8034) 241,037 (8026) 3,075 (8) Pharmacy costs 62,788 (2319) 54,900 (1996) 7,888 (323) Total lifetime costs 306,900 (9155) 295,937 (8716) 10,963 (439)$/QALY (iDM vs OADs) 16,241