糖尿病预防治疗的费用效益分析

目的 了解患者在糖耐量异常阶段进行药物治疗预防糖尿病的经济学意义。方法 以国际公认的两项大型临床研究DPP和STOP-NIDDM为基础,计算每预防1例糖尿病发生所需要的费用,与现有的糖尿病治疗费用相比较。结果 如果以合资二甲双胍治疗,在3年中预防1例糖尿病发生的费用为69 122.95元;以阿卡波糖治疗,3.3年中预防1例糖尿病发生的费用为154 116.05元;以国产二甲双胍进行治疗,3年预防1例糖尿病发生的费用为21666.63元。现有状况下上海市糖尿病患者的年均治疗费用为9143.70元。结论 对糖耐量异常患者进行药物预防治疗,总体医疗费用较大。药物费用在治疗的总体费用中所占比例较大。选用经济、有效的药物是节省费用的关键。深入的临床研究尤其是预防糖尿病及其并发症作用将进一步揭示糖尿病预防治疗的经济学意义。

Cost-effective analysis of preventive treatment on diabetes

Objective To evaluate the cost-effectiveness of preventive treatment on diabetes, usingmetformin or acarbose among patients with impaired glucose tolerance. Methods Using data from diabetesprevention program (DPP) and STOP-NIDDM study, we evaluated the cost of preventing one new onset ofdiabetes in Shanghai, and to compare its cost with the current treatment cost. Results If metformin wasused for preventive treatment as in DPP study, a total cost of 69 122. 95RMB was needed for preventingone new onset of diabetes in three years period. If acarbose was used for preventive treatment as in STOP-NIDDM, then 154 116. 05RMB was the cost to prevent one diabetes in 3. 3 years of treatment. However,if the generic metformin was used, the total cost was only 21 666. 63RMB for the 3-years treatment. Datashowed that the average cost for treating diabetes per year was 9143.70 RMB in Shanghai. ConclusionThe total cost of diabetes prevention was formidable, although generic metformin showed the trend of cost-effective. The cost of drugs took the biggest part of the total cost. To choose the cheap but effective drugfor treatment might save a large part of the cost. Further clinical research concerning the prevention ofcomplications might provide us with more information on the cost-effectiveriess of preventive treatment ondiabetes.