PMID- 23738910
OWN - NLM
STAT- MEDLINE
DCOM- 20140407
LR  - 20221207
IS  - 1941-837X (Electronic)
IS  - 1369-6998 (Linking)
VI  - 16
IP  - 8
DP  - 2013 Aug
TI  - Evaluation of insulin initiation on resource utilization and direct costs of 
      treatment over 12 months in patients with type 2 diabetes in Europe: results from 
      INSTIGATE and TREAT observational studies.
PG  - 1022-35
LID - 10.3111/13696998.2013.812040 [doi]
AB  - OBJECTIVES: To describe the changes in resource utilization in seven European 
      countries (Germany, Greece, Portugal, Romania, Sweden, Spain, and Turkey) and 
      direct costs in four European countries (Germany, Spain, Sweden, and Greece) over 
      the first 12 months of insulin treatment in patients with type 2 diabetes 
      mellitus (T2DM). METHODS: INSTIGATE and TREAT (2005-2010) were 
      non-interventional, prospective, observational studies in patients with T2DM and 
      initiating insulin for the first time. A 6-month retrospective data capture was 
      conducted at baseline (insulin initiation) followed by prospective data 
      collections at  approximately 3, 6, and 12 months. Statistical analyses were descriptive; 
      estimated costs are presented as nominal values. RESULTS: This study presents 
      data for 1450 patients. Overall, in the first 6 months after insulin initiation, 
      the use and cost of blood glucose monitoring and insulin increased, while the 
      cost of oral diabetic medication decreased. Contributors to total direct costs 
      differed between countries. Ranges of total mean direct costs over the 6-month 
      period before insulin initiation were euro489.10-euro658.50 (Greece-Spain); 0-6 months 
      after insulin initiation, euro573.40-euro1084.70 (Greece-Spain); and 6-12 months after 
      insulin initiation, euro495.80-euro859.30 (Greece-Germany). Thus, the mean cost of 
      treatment increased in all countries in the first 6 months after insulin 
      initiation and then returned to baseline except in Germany. LIMITATIONS: Overall, 
      15% of patients were lost to follow-up over 12 months. Costs were not pro-rated 
      to account for variation of visits. Participating centres may not have been fully 
      representative of all levels of care. CONCLUSIONS: Contributors to total cost 
      differed between countries, potentially reflecting local clinical practice 
      patterns and insulin regimens. In each country, mean direct total costs of T2DM 
      care increased during the first 6 months after insulin initiation and decreased 
      thereafter.
FAU - Brismar, Kerstin
AU  - Brismar K
AD  - Department of Molecular Medicine and Surgery, Karolinska Institutet, and 
      Department of Endocrinology, Metabolism and Diabetes, Karolinska University 
      Hospital, Stockholm, Sweden.
FAU - Benroubi, Marianna
AU  - Benroubi M
FAU - Nicolay, Claudia
AU  - Nicolay C
FAU - Schmitt, Henry
AU  - Schmitt H
FAU - Giaconia, Joseph
AU  - Giaconia J
FAU - Reaney, Matthew
AU  - Reaney M
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20130621
PL  - England
TA  - J Med Econ
JT  - Journal of medical economics
JID - 9892255
RN  - 0 (Blood Glucose)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
SB  - IM
MH  - Aged
MH  - Blood Glucose
MH  - Blood Glucose Self-Monitoring
MH  - Diabetes Complications
MH  - Diabetes Mellitus, Type 2/drug therapy/*economics
MH  - Europe
MH  - Female
MH  - Glycated Hemoglobin
MH  - Health Services/*economics/*statistics & numerical data
MH  - Humans
MH  - Hypoglycemic Agents/*economics/therapeutic use
MH  - Insulin/*economics/therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Models, Economic
MH  - Prospective Studies
MH  - Retrospective Studies
MH  - Socioeconomic Factors
EDAT- 2013/06/07 06:00
MHDA- 2014/04/08 06:00
CRDT- 2013/06/07 06:00
PHST- 2013/06/07 06:00 [entrez]
PHST- 2013/06/07 06:00 [pubmed]
PHST- 2014/04/08 06:00 [medline]
AID - 10.3111/13696998.2013.812040 [doi]
PST - ppublish
SO  - J Med Econ. 2013 Aug;16(8):1022-35. doi: 10.3111/13696998.2013.812040. Epub 2013 
      Jun 21.