You are here

Article Text

Article menu

Download PDFPDF

XML
Clinical Care/Education/Nutrition
Research
Cost-effectiveness analysis of a pharmacotherapeutic empowerment strategy for patients with type 2 diabetes mellitus
  1. Ana Carolina Oliveira Gonçalves1,
  2. Maurílio de Souza Cazarim2,
  3. Cristina Sanches3,
  4. Leonardo Regis Leira Pereira2,
  5. Ana Márcia Tomé Camargos3,
  6. Jéssica Azevedo Aquino3,
  7. Andre Oliveira Baldoni3
  1. 1Universidade Federal de São João del-Rei - Campus CCO, Sao Joao del-Rei, Brazil
  2. 2Faculty of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
  3. 3Faculdade de Farmácia, Universidade Federal de Sao Joao del-Rei - Campus CCO, Sao Joao del-Rei, Brazil
  1. Correspondence to Dr Ana Carolina Oliveira Gonçalves; aco_goncalves{at}yahoo.com.br

Abstract

Background The economic feasibility of pharmacotherapeutic empowerment of patients with type 2 diabetes mellitus (DM2) is still not well established.

Objectives To evaluate the cost-effectiveness of an individual pharmacotherapeutic empowerment strategy (IPES) for patients with DM2.

Methods This is a cost-effectiveness study nested in a non-randomized clinical trial with patients ≥18 years of age, of both genders, with low and moderate cardiovascular risks. This study was carried out from the perspective of the municipal health system of Divinópolis in Minas Gerais state, and compared patients submitted to an IPES and patients who received only traditional care, 1 year before the beginning of the intervention (baseline) and 1 year after its completion (follow-up). The costs of the services offered by the municipality were computed, and in the intervention group IPES costs were included. Glycated hemoglobin (A1c) was the effectiveness parameter adopted. Cost-effectiveness ratio analyses, incremental cost-effectiveness ratio (ICER), and sensitivity analysis were performed.

Results In the analysis of cost-effectiveness, it is observed that a reduction of 0.359 in A1c costs US$708.47 in the intervention group and a reduction of 0.170 costs US$1927.13 in the control group. Thus, the ICER is US$387.66 per patient/year. In the sensitivity analysis, it was observed that the IPES was dominant in 19.8% of the simulated scenarios and cost-effective in 80.2%.

Conclusions The IPES is an alternative that presents economic feasibility for the municipal public health system scenario. The absence of randomization in patient selection is a limitation of this study.

  • endocrinology diabetes
  • pharmacoeconomics
  • cost-effectiveness
  • public health

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjdrc-2018-000647

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Contributors ACOG, MSC, CS, AMTC and AOB contributed to the design, collection, analysis and interpretation of data. LRLP and JAA participated in the critical review of the work content. All authors participated in the final approval of the version to be published.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval The study was approved by the Research Ethics Committee of the Federal University of São João Del-Rei, Dona Lindu Central-West (Centro-Oeste) Campus (UFSJ-CCO), No CAAE 32787914.0.0000.5545, and is registered in the Brazilian Registry of Clinical Trials (ReBEC) under No RBR-6t4qmn.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.