The Impact of Unrelated Future Medical Costs on Economic Evaluation Outcomes for Different Models of Diabetes

Ting Zhao, Michelle Tew, Talitha Feenstra, Pieter Baal, Michael Willis, William J. Valentine, Philip M. Clarke, Barnaby Hunt, James Altunkaya, An Tran-Duy, Richard F. Pollock, Samuel J. P. Malkin, Andreas Nilsson, Phil McEwan, Volker Foos, Jose Leal, Elbert S. Huang, Neda Laiteerapong, Mark Lamotte, Harry Smolen, Jianchao Quan, Luís Martins, Mafalda Ramos and Andrew J. Palmer ()
Additional contact information
Ting Zhao: University of Tasmania
Michelle Tew: University of Melbourne
Talitha Feenstra: University of Groningen
Pieter Baal: Erasmus University Rotterdam
Michael Willis: The Swedish Institute for Health Economics
William J. Valentine: Ossian Health Economics and Communications
Philip M. Clarke: University of Oxford
Barnaby Hunt: Ossian Health Economics and Communications
An Tran-Duy: University of Melbourne
Richard F. Pollock: Covalence Research Ltd
Samuel J. P. Malkin: Ossian Health Economics and Communications
Andreas Nilsson: The Swedish Institute for Health Economics
Phil McEwan: Health Economics and Outcomes Research Ltd.
Volker Foos: Health Economics and Outcomes Research Ltd.
Jose Leal: University of Oxford
Elbert S. Huang: The University of Chicago
Neda Laiteerapong: University of Chicago
Mark Lamotte: Th(is)2Modeling
Harry Smolen: Medical Decision Modeling Inc.
Jianchao Quan: University of Hong Kong
Luís Martins: Th(is)2Modeling
Mafalda Ramos: Th(is)2Modeling
Andrew J. Palmer: University of Tasmania

Applied Health Economics and Health Policy, 2024, vol. 22, issue 6, No 10, 869 pages

Abstract: Abstract Objective This study leveraged data from 11 independent international diabetes models to evaluate the impact of unrelated future medical costs on the outcomes of health economic evaluations in diabetes mellitus. Methods Eleven models simulated the progression of diabetes and occurrence of its complications in hypothetical cohorts of individuals with type 1 (T1D) or type 2 (T2D) diabetes over the remaining lifetime of the patients to evaluate the cost effectiveness of three hypothetical glucose improvement interventions versus a hypothetical control intervention. All models used the same set of costs associated with diabetes complications and interventions, using a United Kingdom healthcare system perspective. Standard utility/disutility values associated with diabetes-related complications were used. Unrelated future medical costs were assumed equal for all interventions and control arms. The statistical significance of changes on the total lifetime costs, incremental costs and incremental cost-effectiveness ratios (ICERs) before and after adding the unrelated future medical costs were analysed using t-test and summarized in incremental cost-effectiveness diagrams by type of diabetes. Results The inclusion of unrelated costs increased mean total lifetime costs substantially. However, there were no significant differences between the mean incremental costs and ICERs before and after adding unrelated future medical costs. Unrelated future medical cost inclusion did not alter the original conclusions of the diabetes modelling evaluations. Conclusions For diabetes, with many costly noncommunicable diseases already explicitly modelled as complications, and with many interventions having predominantly an effect on the improvement of quality of life, unrelated future medical costs have a small impact on the outcomes of health economic evaluations.

Date: 2024
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DOI: 10.1007/s40258-024-00914-z

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