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Cited by 128Health Systems, Economic Evaluations, Quality of LifeDiabetes Treatment and ManagementDiabetes, Cardiovascular Risks, and Lipoproteins

The DOI matches its Crossref record; 65 of the 69 references it cites were found in a registry or an index.

Intensive lifestyle changes or metformin in patients with impaired glucose tolerance: Modeling the long-term health economic implications of the diabetes prevention program in Australia, France, Germany, Switzerland, and the United Kingdom

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Palmer, Andrew J., Roze, Stéphane, Valentine, William J., Spinas, Giatgen A., Shaw, Jonathan E., Zimmet, Paul Z.·2004·Clinical Therapeutics
DOI 10.1016/s0149-2918(04)90029-x
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Abstract

Background In the Diabetes Prevention Program (DPP), interventions with metformin (plus standard lifestyle advice) or intensive lifestyle changes (ILC) reduced the risk of developing type 2 diabetes mellitus (DM) by 31% and 58%, respectively, versus control (standard lifestyle advice only) in patients with impaired glucose tolerance (IGT).Objective The goal of this study was to establish whether implementing the active treatments used in the DPP would be cost-effective in Australia, France, Germany, Switzerland, and the United Kingdom.Methods A Markov model simulated 3 states-IGT, type 2 DM, and deceased-using probabilities from the DPP and published data. Country-specific direct costs were used throughout.Results Assuming only within-trial effects and costs of interventions, both metformin and ILC improved life expectancy versus control. Mean improvements in nondiscounted life expectancy were 0.11 and 0.22 years for metformin and ILC, respectively. Both interventions were associated with cost savings versus control in all countries except the United Kingdom, where a small increase in costs was observed in both intervention arms. When a lifetime effect of interventions was assumed, incremental improvements in life expectancy were 0.35 and 0.90 years for metformin and ILC, respectively. Results were sensitive to probabilities of developing type 2 DM, the projected long-term duration of effect of interventions after the 3-year trial period, the relative risk of mortality for type 2 DM compared with IGT, and the costs of implementing the interventions.Conclusions Based on probabilities from the DPP and published data, in this model analysis, incorporation of the DPP interventions into clinical practice in 5 developed countries was projected to lead to an increase in DM-free years of life, improvements in life expectancy, and either cost savings or minor increases in costs compared with standard lifestyle advice in a population with IGT. Thus, financial constraints should not prevent the implementation of DM prevention programs.

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Crossref · 10.1016/s0149-2918(04)90029-x

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Show all 69 references

Research works printed but not linked: 6

  1. 2000, German recommendations for health care economic evaluation studies. Revised version of the Hannover consensus, Med Min (Munich), 95, 52
  2. 1999, German recommendations for health economic evaluation. Revised edition of the Hannoverian consensus, Dtsch Med Wochenschr, 124, 1503
  3. Detsky, 1994, Using cost-effectiveness analysis for formulary decision making: From theory into practice, PharmacoEconomics, 6, 281
  4. Palmer, 2002, Cost effectiveness issues in type 2 diabetes prevention in the USA, Diabetes., 51, A279
  5. Palmer, 2002, Improvements in life expectancy with lifestyle changes or metformin in overweight, glucose intolerant patients: Modeling the long term impli cations of the Diabetes Prevention Program, Diabetes, 51, A420
  6. Wenying, 2001, The preventive effect of acarbose and metformin on the progression to diabetes mellitus in the IGT population: A 3 year mul ticenter prospective study, Chin J Endocrinol Metab, 17, 131

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Metadata

Authors
Palmer, A. J., Roze, S., Valentine, W. J., Spinas, G. A., Shaw, J. E., & Zimmet, P. Z.
Affiliations
  • IQVIA (United Kingdom) (GB)
  • University Hospital Zurich (CH)
ORCID
Venue
Clinical Therapeutics
Publisher
Elsevier BV
Published
2004-02
Volume
26
Issue
2
Pages
304-321
ISSN
0149-2918 (ISSN-L)
DOI
10.1016/s0149-2918(04)90029-x
OpenAlex
W2146089294
Cited by
128
References
69
Citations by year
2026: 1 · 2025: 2 · 2024: 3 · 2023: 4 · 2022: 1 · 2021: 1 · 2020: 4 · 2019: 2 · 2018: 3 · 2017: 6 · 2016: 3 · 2015: 8 · 2014: 5 · 2013: 5 · 2012: 7
FWCI
26.24
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinical Therapeutics (publishedVersion)
  • PubMed (publishedVersion)
  • eCite Digital Repository (University of Tasmania) (submittedVersion)
  • Figshare (submittedVersion, cc-by)
Topics
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
metformin, intensive lifestyle intervention, impaired glucose tolerance, type 2 diabetes prevention, Diabetes Prevention Program, cost-effectiveness, life expectancy, Markov model
MeSH terms
Adult, Australia, Cost-Benefit Analysis, Diabetes Mellitus, Type 2, Diet, Europe, Humans, Hypoglycemic Agents, Life Expectancy, Life Style, Markov Chains, Metformin, Middle Aged, Preventive Health Services, Exercise

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