PMID- 17586072
OWN - NLM
STAT- MEDLINE
DCOM- 20080731
LR  - 20131121
IS  - 1874-1754 (Electronic)
IS  - 0167-5273 (Linking)
VI  - 127
IP  - 1
DP  - 2008 Jun 23
TI  - Is fenofibrate a cost-saving treatment for middle-aged individuals with type II 
      diabetes? An economic analysis of the FIELD Study.
PG  - 51-6
AB  - BACKGROUND: The aim of this study was to determine the impact of fenofibrate 
      therapy on health care costs in middle-aged patients with type II diabetes at 
      high risk of future cardiovascular events. METHODS: We undertook an economic 
      analysis of the FIELD study conducted from the perspective of the third party 
      payer (direct costs) with all "within trial" health care costs derived from 
      reported clinical outcomes using pooled data from all 9795 study participants. 
      All analyses were performed on an intention-to-treat-basis and items of 
      expenditure were derived from 2001/2002 health economic data: comparing 
      Diagnostic Related Groupings (DRG) costs of major morbid events from an average 
      of unit costs derived from three European countries (UK, France and Germany). 
      RESULTS: Despite the additional cost of applying fenofibrate therapy, that was 
      off-set slightly by a reduced need for supplementary lipid-lowering therapy (a 
      net cost increase of 20,495 Euros per 1000 person years to apply combined 
      lipid-lowering therapy), fenofibrate was associated with a net saving of 23,607 
      Euros in health care costs per 1000 person years of follow-up. This represents an 
      approximate 10% net saving in health care costs (total of 227,111 versus 203,415 
      Euros for the placebo and treatment groups, respectively). As such, based on the 
      95% CI calculated for observed event rates per 1000 person years at risk, the 
      cost impact of fenofibrate therapy ranged from a 24% net saving to a 4% net 
      increase in health care costs relative to treatment with placebo. When the 
      highest compared to lowest DRG unit costs were applied to observed event rates, 
      the cost impact of fenofibrate therapy varied from a 5% to 12% net saving (low 
      versus high cost health care models) in health care costs relative to usual care. 
      CONCLUSION: The robust nature of these analyses suggest potential cost advantages 
      in the longer-term by applying fenofibrate in this type of patient cohort (quite 
      possibly in combination with statin therapy) via a marked reduction in costly 
      cardiac events and procedures.
FAU - Carrington, Melinda
AU  - Carrington M
AD  - Baker Heart Research Institute, Melbourne, Victoria, Australia.
FAU - Stewart, Simon
AU  - Stewart S
LA  - eng
PT  - Journal Article
DEP - 20070621
PL  - Netherlands
TA  - Int J Cardiol
JT  - International journal of cardiology
JID - 8200291
RN  - 0 (Hypolipidemic Agents)
RN  - 0 (Placebos)
RN  - U202363UOS (Fenofibrate)
SB  - IM
MH  - Aged
MH  - Cost Savings
MH  - Cost-Benefit Analysis
MH  - Diabetes Mellitus, Type 2/*drug therapy/economics
MH  - *Economics, Pharmaceutical
MH  - Female
MH  - Fenofibrate/economics/*therapeutic use
MH  - Humans
MH  - Hypolipidemic Agents/economics/*therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*prevention & control
MH  - Placebos
MH  - Randomized Controlled Trials as Topic
MH  - Stroke/prevention & control
EDAT- 2007/06/26 09:00
MHDA- 2008/08/01 09:00
CRDT- 2007/06/26 09:00
PHST- 2007/01/18 00:00 [received]
PHST- 2007/04/01 00:00 [accepted]
PHST- 2007/06/26 09:00 [pubmed]
PHST- 2008/08/01 09:00 [medline]
PHST- 2007/06/26 09:00 [entrez]
AID - S0167-5273(07)00928-X [pii]
AID - 10.1016/j.ijcard.2007.04.040 [doi]
PST - ppublish
SO  - Int J Cardiol. 2008 Jun 23;127(1):51-6. doi: 10.1016/j.ijcard.2007.04.040. Epub 
      2007 Jun 21.