Health and economic effects of adding @entity6347 to XXXX to achieve dual control of glycosylated hemoglobin and postprandial glucose levels in a model of @entity6 .

@entity1 @entity4051 @entity8 @entity66 @entity6 @entity2412 @entity6347 @entity204 @entity2449
BACKGROUND: @entity6 is a common disease whose complications have great costs, both in quality of life and expense of treatment. Improving glycemic control, as measured by monitoring glycosylated hemoglobin (HbA1c) levels, can reduce the rate of such complications. OBJECTIVES: The aims of this study were to estimate the lifetime costs associated with @entity2412 in a theoretical population receiving @entity2449 monotherapy and to predict the health and economic effect of improving glycemic control in this theoretical population by combining @entity2449 with @entity6347 . METHODS: A pharmacoeconomic model was developed to simulate the long-term (30 years) complication rates (microvascular and macrovascular) of a cohort of @entity1 with @entity6 . The model simulated each year of life for each @entity1 in a theoretical cohort of 10,000 @entity1 until @entity2412 were present or @entity204 occurred. The mean accumulated costs (direct medical costs for acute care and subsequent care for @entity2412 ), mean survival time, and the frequency of each type of complication were estimated. Both effectiveness and cost data were discounted at 3%. Sensitivity analyses were conducted on key model input parameters. RESULTS: Average costs of treating complications in theoretical @entity1 undergoing @entity2449 monotherapy were estimated at  29,565 per @entity1 . Savings of  2,742 were estimated per @entity1 for all complications--particularly, @entity8 ( 1,166) and @entity66 ( 632)--when @entity6347 was added. The cost-effectiveness ratio of adding @entity6347 to @entity2449 was estimated at  27,131 per undiscounted life-year gained (95% CI,  23,710- 28,577) or  43,024 (95% CI,  37,285- 45,193) per additional discounted life-year gained. In the sensitivity analyses, decreasing HbA1c level at baseline, @entity4051 c upward drift, and duration of disease improved survival. CONCLUSIONS: Combination therapy with @entity6347 and @entity2449 , compared with @entity2449 alone, was predicted to reduce the frequency of complications and, thus, treatment costs in this theoretical model. The major factor in cost savings was fewer complications due to @entity8 . The increased drug treatment costs were expected to be offset by the long-term savings from reducing complication rates.
