Originales
Coste-efectividad de la adición de acarbosa al tratamiento de pacientes con diabetes tipo 2 en España
Cost-effectiveness of the addition of acarbose to the treatment of patients with type-2 diabetes in Spain
Carme Piñola,
, Stephane Rozeb, William Valentineb, Thomas Eversc
Autor para correspondencia
carmen.pinol.cp@bayer.es
Correspondencia: Carme Piñol. Unidad de Farmacoeconomía y Relaciones Institucionales. Departamento de Investigación y Desarrollo. Química Farmacéutica Bayer, S. A. Pau Claris, 196. 08037 Barcelona. España.
Correspondencia: Carme Piñol. Unidad de Farmacoeconomía y Relaciones Institucionales. Departamento de Investigación y Desarrollo. Química Farmacéutica Bayer, S. A. Pau Claris, 196. 08037 Barcelona. España.
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A., Barcelona, España" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "CORE-Center for Outcomes Research, Basilea, Suiza" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] 2 => array:3 [ "entidad" => "Bayer Healthcare AG, Wuppertal, Alemania" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "Correspondencia: Carme Piñol. Unidad de Farmacoeconomía y Relaciones Institucionales. Departamento de Investigación y Desarrollo. Química Farmacéutica Bayer, S. A. Pau Claris, 196. 08037 Barcelona. España." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Cost-effectiveness of the addition of acarbose to the treatment of patients with type-2 diabetes in Spain" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2006-01-13" "fechaAceptado" => "2006-05-22" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec13855" "palabras" => array:4 [ 0 => "Coste efectividad" 1 => "Diabetes tipo 2" 2 => "Acarbosa" 3 => "Años de vida ajustados por calidad" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec13856" "palabras" => array:4 [ 0 => "Cost-effectiveness" 1 => "Type 2 diabetes" 2 => "Acarbose" 3 => "Quality-adjusted life years" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p class="elsevierStyleSimplePara elsevierViewall">Evaluar el coste-efectividad de la adición de acarbosa al tratamiento de pacientes con diabetes mellitus tipo 2 (DM2) en España.</p> <span class="elsevierStyleSectionTitle">Métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Se utilizó el CORE Diabetes Model (modelo de simulación informática publicado y validado) para proyectar a largo plazo los resultados clínicos y de costes de la DM2. Las probabilidades de transición y los riesgos se obtuvieron de distintas publicaciones. Los efectos del tratamiento y las características basales de la cohorte se obtuvieron de un metaanálisis. Los costes directos se extrajeron de diversas publicaciones y se proyectaron a lo largo de la vida de los pacientes bajo la perspectiva del Sistema Nacional de Salud de España. Los costes y beneficios fueron descontados en un 3% anual. Se realizaron análisis de sensibilidad.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">El tratamiento con acarbosa se asoció con mejoras en la esperanza de vida (0,23 años) y en los años de vida ajustados por calidad (AVAC) (0,21 años). Los costes directos fueron en promedio, por paciente, de 468 A más caros con acarbosa que con placebo. La razón de coste-efectividad incremental fue de 2.002 €/año de vida ganado y de 2.199 €/AVAC ganado. La curva de aceptabilidad mostró que con una disponibilidad a pagar de 20.000 €, generalmente aceptada como muy buen valor monetario, el tratamiento con acarbosa se asoció con una probabilidad del 93,5% de ser costeefectiva.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Este estudio económico a largo plazo mostró que la adición de acarbosa al tratamiento de pacientes con DM2 produjo mejoras en la esperanza de vida y en los AVAC de estos pacientes.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p class="elsevierStyleSimplePara elsevierViewall">To assess the cost-effectiveness of the addition of acarbose to existing treatment in patients with type 2 diabetes mellitus (DM2) in Spain.</p> <span class="elsevierStyleSectionTitle">Methods</span><p class="elsevierStyleSimplePara elsevierViewall">The CORE Diabetes Model (a published and validated computer simulation model) was used to project longterm clinical and cost outcomes in DM2. Transition probabilities and risk adjustments were derived from published sources. Treatment effects and baseline cohort characteristics were based on a meta-analysis. Direct costs were retrieved from published sources and projected over patient lifetimes from the perspective of the Spanish National Health Service. Costs and clinical benefits were discounted at 3% per year. Sensitivity analyses were performed.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Acarbose treatment was associated with improved life expectancy (0.23 years) and quality-adjusted life years (QALY) (0.21 years). Direct costs were on average € 468 per patient more expensive with acarbose than with placebo. The incremental cost-effectiveness ratios were € 2,002 per life year gained and € 2,199 per QALY gained. An acceptability curve showed that with a willingness to pay € 20,000, which is generally accepted to represent very good value for money, acarbose treatment was associated with a 93.5% probability of being cost-effective.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">This long-term economic study showed that the addition of acarbose to existing therapy for DM2 was associated with improvements in life expectancy and QALYs in these patients.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:33 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Global prevalence of diabetes: estimates for the year 2000 and projections for 2030" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S. Wild" 1 => "G. 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Información del artículo
ISSN: 02139111Idioma original: Español
DOI:10.1157/13101034
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