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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Ou, Huang-Tz Chen, Yen-Ting Liu, Ya-Ming Wu, Jin-Shang |
| Description | Author Affiliation: Ou HT ( Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan. Electronic address: huangtz@mail.ncku.edu.tw.); Chen YT ( Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.); Liu YM ( Department of Economics, National Cheng Kung University, Tainan, Taiwan.); Wu JS ( Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan) |
| Abstract | OBJECTIVE: To assess the cost-effectiveness of metformin-based dual therapies associated with cardiovascular disease (CVD) risk in a Chinese population with type 2 diabetes. METHODS: We utilized Taiwan's National Health Insurance Research Database (NHIRD) 1997-2011, which is derived from the claims of National Health Insurance, a mandatory-enrollment single-payer system that covers over 99% of Taiwan's population. Four metformin-based dual therapy cohorts were used, namely a reference group of metformin plus sulfonylureas (Metformin-SU) and metformin plus acarbose, metformin plus thiazolidinediones (Metformin-TZD), and metformin plus glinides (Metformin-glinides). Using propensity scores, each subject in a comparison cohort was 1:1 matched to a referent. The effectiveness outcome was CVD risk. Only direct medical costs were included. The Markov chain model was applied to project lifetime outcomes, discounted at 3% per annum. The bootstrapping technique was performed to assess uncertainty in analysis. RESULTS: Metformin-glinides was most cost-effective in the base-case analysis; Metformin-glinides saved \$194 USD for one percentage point of reduction in CVD risk, as compared to Metformin-SU. However, for the elderly or those with severe diabetic complications, Metformin-TZD, especially pioglitazone, was more suitable; as compared to Metformin-SU, Metformin-TZD saved \$840.1 USD per percentage point of reduction in CVD risk. Among TZDs, Metformin-pioglitazone saved \$1831.5 USD per percentage point of associated CVD risk reduction, as compared to Metformin-rosiglitazone. CONCLUSIONS: When CVD is considered an important clinical outcome, Metformin-pioglitazone is cost-effective, in particular for the elderly and those with severe diabetic complications. |
| File Format | HTM / HTML |
| ISSN | 01688227 |
| Journal | Diabetes Research and Clinical Practice |
| Volume Number | 116 |
| e-ISSN | 18728227 |
| Language | English |
| Publisher | Elsevier |
| Publisher Date | 2016-06-01 |
| Publisher Place | Ireland |
| Access Restriction | One Nation One Subscription (ONOS) |
| Subject Keyword | Discipline Endocrinology |
| Content Type | Text |
| Resource Type | Article |
| Subject | Endocrinology, Diabetes and Metabolism Internal Medicine Endocrinology |
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