The cost-effectiveness of different management strategies for XXXX : a Swiss perspective.

@entity1 @entity8 @entity64 @entity6 @entity1939 @entity1723 @entity1270 @entity989 @entity583 @entity454
AIMS/HYPOTHESIS: A computer model was developed to determine the health outcomes and economic consequences of different combinations of @entity6 interventions in newly diagnosed @entity1 with @entity1723 in Switzerland. METHODS: We modelled seven complications of @entity6 : hypoglycaemia, @entity1270 , acute @entity583 , @entity64 , lower extremity amputation, @entity8 , and @entity989 . Transition probabilities and costs were taken from published literature. The Swiss health insurance payer perspective was taken. Various combinations of @entity6 management strategies, including intensive or conventional insulin therapy and screening and treatment strategies for @entity8 were defined. Life expectancy, cumulative incidences of complications, and mean expected total lifetime costs per @entity1 were calculated under six different management strategies. Incremental cost-effectiveness ratios were calculated in terms of costs per life-year gained compared with conventional insulin therapy alone. RESULTS: The addition of screening for microalbuminuria and @entity989 followed by appropriate treatment, if detected, were cost saving, with reduction in cumulative incidence of @entity454 and @entity1939 respectively, and, in the case of microalbulminuria screening and treatment, an improvement in life expectancy. Intensive therapy improved life expectancy but increased total lifetime costs. CONCLUSION/INTERPRETATION: Optimal management of Type I @entity6 @entity1 , including secondary and tertiary prevention, leads to reduced complications and improved life expectancy, with the increased costs of prevention offset to varying degrees by cost savings due to complications avoided.
