Michał Jakubczyk1, Izabela Lipka2, Justyna Pawęska2, Maciej Niewada3, Elżbieta Rdzanek2, Jelka Zaletel4, Antonio Ramírez de Arellano5, Tomáš Doležal6,7, Biljana Chekorova Mitreva8, Bence Nagy9, Guenka Petrova10, Tereza Šarić11, John Yfantopoulos12, Marcin Czech13,14. 1. a Decision Analysis and Support Unit, Warsaw School of Economics , Poland ; 2. b HealthQuest spółka z ograniczoną odpowiedzialnością Sp. K , Warsaw , Poland ; 3. c Department of Experimental and Clinical Pharmacology , Medical University of Warsaw , Poland ; 4. d Department of Endocrinology, Diabetes and Metabolic Diseases , University Medical Centre , Ljubljana , Slovenia ; 5. e Novo Nordisk Pharma , Spain ; 6. f Institute of Health Economics and Technology Assessment , Prague , the Czech Republic ; 7. g Department of Pharmacology, 2nd Faculty of Medicine , Prague , the Czech Republic ; 8. h Novo Nordisk Pharma, Macedonia, the former Yugoslav Republic of Macedonia ; 9. i Healthware Consulting Ltd , Budapest , Hungary ; 10. j Department of Social Pharmacy and Pharmacoeconomics, Faculty of Pharmacy , Medical University of Sofia , Bulgaria ; 11. k Promeritus savjetovanje Ltd. , Zagreb , Croatia ; 12. l School of Economics and Political Science , University of Athens , Greece ; 13. m Department of Pharmacoeconomics , Medical University of Warsaw , Poland ; 14. n Business School, Warsaw University of Technology , Poland.
Abstract
OBJECTIVE: Complications contribute largely to the economic gravity of diabetes mellitus (DM). How they arise and are treated differs substantially between countries. This paper assesses the total annual, direct, and indirect cost of severe hypoglycemia events (SHEs) in nine European countries: Bulgaria, Croatia, the Czech Republic, Greece, Hungary, Macedonia/the former Yugoslav Republic of Macedonia (MK), Poland, Slovenia, and Spain. METHODS: Data was collected on epidemiology, treatment structure, SHE-driven resource consumption, and unit costs. Two systematic reviews-on the SHE rates and the resources used for treatment-and data on the days-of-work lost due to SHE along with salaries and employment rates were used. The total SHE cost in each country was calculated and how the differences are driven by individual parameters was analysed. RESULTS: The annual costs of SHEs varied in absolute terms from €379,951.25 in MK up to €58,429,684.40 in Spain, or-when expressed per one drug-treated DM patient-from €5.47 in Bulgaria up to €17.74 in Spain. Indirect cost constituted between 6.01% (MK) and 26.49% (Hungary) of the total cost. The differences between countries are driven mostly by the cost of treating a single event, and this is related to general differences in prices. LIMITATIONS: The main limitation is the lack of good quality data in some parts, and the necessity to use mean-value imputations, experts' opinions, etc. Additionally, we only considered DM treatment as the SHE driver, while other elements, e.g. style of living, may contribute substantially. CONCLUSIONS: A common framework can be applied to estimate the economic burden of SHE in various countries, allowing one to identify the drivers of differences in cost. Treating DM is complex, and so no resolute conclusions ought to be drawn as to whether SHE management is better in one country than another.
OBJECTIVE: Complications contribute largely to the economic gravity of diabetes mellitus (DM). How they arise and are treated differs substantially between countries. This paper assesses the total annual, direct, and indirect cost of severe hypoglycemia events (SHEs) in nine European countries: Bulgaria, Croatia, the Czech Republic, Greece, Hungary, Macedonia/the former Yugoslav Republic of Macedonia (MK), Poland, Slovenia, and Spain. METHODS: Data was collected on epidemiology, treatment structure, SHE-driven resource consumption, and unit costs. Two systematic reviews-on the SHE rates and the resources used for treatment-and data on the days-of-work lost due to SHE along with salaries and employment rates were used. The total SHE cost in each country was calculated and how the differences are driven by individual parameters was analysed. RESULTS: The annual costs of SHEs varied in absolute terms from €379,951.25 in MK up to €58,429,684.40 in Spain, or-when expressed per one drug-treated DMpatient-from €5.47 in Bulgaria up to €17.74 in Spain. Indirect cost constituted between 6.01% (MK) and 26.49% (Hungary) of the total cost. The differences between countries are driven mostly by the cost of treating a single event, and this is related to general differences in prices. LIMITATIONS: The main limitation is the lack of good quality data in some parts, and the necessity to use mean-value imputations, experts' opinions, etc. Additionally, we only considered DM treatment as the SHE driver, while other elements, e.g. style of living, may contribute substantially. CONCLUSIONS: A common framework can be applied to estimate the economic burden of SHE in various countries, allowing one to identify the drivers of differences in cost. Treating DM is complex, and so no resolute conclusions ought to be drawn as to whether SHE management is better in one country than another.
Entities:
Keywords:
Diabetes mellitus; cost study; direct cost; indirect cost; severe hypoglycemia
Authors: Witesh Parekh; Nicki Hoskins; James Baker-Knight; Antonio Ramirez de Arellano; Pedro Mezquita Raya Journal: Diabetes Ther Date: 2017-06-26 Impact factor: 2.945
Authors: Martin Haluzik; Adam Kretowski; Krzysztof Strojek; Leszek Czupryniak; Andrej Janez; Peter Kempler; Michal Andel; Tsvetalina Tankova; Mihail Boyanov; Lea Smircic Duvnjak; Laszlo Madacsy; Iwona Tarnowska; Marcin Zychma; Nebojsa Lalic Journal: Diabetes Ther Date: 2018-03-09 Impact factor: 2.945