PMID- 25350645
OWN - NLM
STAT- MEDLINE
DCOM- 20151125
LR  - 20221207
IS  - 1941-837X (Electronic)
IS  - 1369-6998 (Linking)
VI  - 18
IP  - 2
DP  - 2015 Feb
TI  - Economic simulation of canagliflozin and sitagliptin treatment outcomes in 
      patients with type 2 diabetes mellitus with inadequate glycemic control.
PG  - 113-25
LID - 10.3111/13696998.2014.980503 [doi]
AB  - OBJECTIVES: This study examines the association between changes in 
      diabetes-related quality measures (QMs) (HbA1c, systolic and diastolic blood 
      pressure [BP], low-density lipoprotein cholesterol [LDL-C], and body weight) and 
      healthcare costs in Type 2 diabetes mellitus (T2DM) patients. It also performs an 
      economic simulation that evaluates the cost implications of the changes in QMs 
      and of the incidence rates (IRs) of adverse events (AEs) associated with 
      canagliflozin (CANA) and sitagliptin (SITA) treatments in a real-world setting. 
      METHODS: Health-insurance claims and electronic medical records from the Reliant 
      Medical Group database (2007-2011) were used to identify adult patients with T2DM 
      receiving metformin and sulfonylurea who did not achieve adequate glycemic 
      control. The association between the changes in QMs and healthcare costs was 
      evaluated using multivariate regression and non-parametric bootstrap methods. 
      AE-related costs were taken from the literature. The cost impact of CANA and SITA 
      outcomes was evaluated using the aforementioned costs and the changes in QMs and 
      the IRs of AEs observed in a recent phase 3 trial comparing CANA and SITA as 
      third oral agent (DIA3015). RESULTS: Eight hundred and fifty-six T2DM patients 
      were identified (mean age = 65.8; female 45.4%). The regression analysis found 
      that increases of 1 percentage point in HbA1C and 1% in systolic and diastolic 
      BP, LDL-C, or weight were associated with a per patient per year (PPPY) cost 
      increase of $4476 (p = 0.028) and $566 (p = 0.006), a decrease of $362 (p = 
      0.070) and $7 (p = 0.817), and an increase of $241 (p = 0.481), respectively. The 
      economic simulation showed that changes in QMs and IRs of AEs equivalent to those 
      reported in DIA3015 would be associated with a reduction in PPPY healthcare costs 
      of $6061 (p = 0.036) for CANA and $2190 (p = 0.098) for SITA. CONCLUSIONS: This 
      study suggests that integrated approaches that manage to control a combination of 
      quality measures are most successful at reducing downstream healthcare costs.
FAU - Lafeuille, Marie-Helene
AU  - Lafeuille MH
AD  - Groupe d'analyse, Ltee, Montreal , QC , Canada.
FAU - Grittner, Amanda Melina
AU  - Grittner AM
FAU - Gravel, Jonathan
AU  - Gravel J
FAU - Bailey, Robert A
AU  - Bailey RA
FAU - Martin, Silas
AU  - Martin S
FAU - Garber, Lawrence
AU  - Garber L
FAU - Duh, Mei Sheng
AU  - Duh MS
FAU - Lefebvre, Patrick
AU  - Lefebvre P
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20141107
PL  - England
TA  - J Med Econ
JT  - Journal of medical economics
JID - 9892255
RN  - 0 (Blood Glucose)
RN  - 0 (Cholesterol, LDL)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
RN  - 0SAC974Z85 (Canagliflozin)
RN  - TS63EW8X6F (Sitagliptin Phosphate)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Blood Glucose
MH  - Blood Pressure
MH  - Body Weight
MH  - Canagliflozin/*economics/therapeutic use
MH  - Cholesterol, LDL
MH  - Comorbidity
MH  - Computer Simulation
MH  - Costs and Cost Analysis
MH  - Diabetes Mellitus, Type 2/complications/*drug therapy
MH  - Female
MH  - Glycated Hemoglobin
MH  - Humans
MH  - Hypoglycemic Agents/*economics/therapeutic use
MH  - Insurance Claim Review
MH  - Male
MH  - Middle Aged
MH  - *Models, Econometric
MH  - Quality Indicators, Health Care
MH  - Sitagliptin Phosphate/*economics/therapeutic use
MH  - Young Adult
OTO - NOTNLM
OT  - Blood pressure
OT  - Canagliflozin
OT  - HbA1c
OT  - Healthcare costs
OT  - LDL-C
OT  - Sitagliptin
OT  - Type 2 diabetes mellitus
EDAT- 2014/10/29 06:00
MHDA- 2015/12/15 06:00
CRDT- 2014/10/29 06:00
PHST- 2014/10/29 06:00 [entrez]
PHST- 2014/10/29 06:00 [pubmed]
PHST- 2015/12/15 06:00 [medline]
AID - 10.3111/13696998.2014.980503 [doi]
PST - ppublish
SO  - J Med Econ. 2015 Feb;18(2):113-25. doi: 10.3111/13696998.2014.980503. Epub 2014 
      Nov 7.