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BMJ Publishing Group, BMJ Open Diabetes Research and Care, 1(9), p. e002177, 2021

DOI: 10.1136/bmjdrc-2021-002177

American Diabetes Association, Diabetes, Supplement_1(67), 2018

DOI: 10.2337/db18-2319-pub

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Developing a Health Economic Model for Asians with Type 2 Diabetes Based on the Japan Diabetes Complications Study and the Japanese Elderly Diabetes Intervention Trial

This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

Cost-effectiveness analyses (CEAs) are becoming increasingly important in Japan following the introduction of the pilot-based health technology assessment (HTA) from April 2016. Although health economic (HE) models for type 2 diabetes (T2D) have been developed, most models are not generalizable to patients in Asia whose risk factor profiles are different from Caucasians, since they are based on risk equations derived from the United Kingdom Prospective Diabetes Study (UKPDS). The objective was to develop a HE model for T2D using risk equations validated in Japanese patients (JJ Risk Engine) designed to meet the criteria in the guidelines of the Ministry of Health, Labour and Welfare in Japan. The model cohort is defined by patient characteristics and four risk factors (HbA1c, BMI, blood pressure and cholesterol), and treatment effects on macro and micro vascular complications and mortality are applied as risk factor modification over specified duration. In addition to outcomes included in the JJ Risk Engine, end-stage renal disease, amputation, hypoglycemia, utilities and costs were incorporated in the model using data available in the literature. The HE model estimates risks of macro and microvascular complications, cost of complications and treatments, quality-adjusted life years (QALYs) and the incremental cost-effectiveness ratio (ICER). Deterministic and probabilistic sensitivity analyses can be conducted for assessment of uncertainty. Simulation settings related to e.g., time horizon, treatment duration, and discount rates can be varied. This HE model offers an opportunity for decision-makers to assess the long-term cost-effectiveness of interventions in Asian patients with T2D. Disclosure S. Tanaka: None. J. Langer: Employee; Self; Novo Nordisk Pharma Ltd.. Stock/Shareholder; Self; Novo Nordisk A/S. T. Morton: Consultant; Self; Novo Nordisk Inc. L. Wilkinson: Employee; Self; Novo Nordisk A/S. S. Tanaka: None. R. Kawasaki: None. T. Moriya: None. C. Horikawa: None. R. Aida: None. A. Araki: None. H. Sone: Research Support; Self; Novo Nordisk Inc., Eli Lilly and Company, MSD K.K., Chugai Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Development Center Asia, Pte. Ltd., Daiichi Sankyo Company, Limited, Ono Pharmaceutical Co., Ltd., Kyowa Hakko Kirin Co., Ltd., Sanofi, Kowa Pharmaceuticals America, Inc., Eisai Inc..