• 作者：Marí ; a Costi^a ; Helen Smith^b ; Jesú ; s Reviriego^a ; Conxa Castell^c ; Alberto Goday^d ; Tatiana Dilla^a ; ^{dilla_tatiana@lilly.com}
• 关键词：Costes sanitarios ; Terapia con insulina ; Diabetes mellitus ; Tipo 2 ; Estudio prospectivo ; Españ ; a
• 刊名：Endocrinolog铆a y Nutrici贸n
• 出版年：2011
• 期刊代码：pca151_15750922
• 类别：med
• 出版时间：June-July 2011
• 卷：58
• 期：6
• 页码：274-282
• 文件大小：167 K

Background and objectives

The INSTIGATE study was designed to assess direct health care costs incurred by patients with type 2 diabetes mellitus (T2DM) who start insulin therapy in Spain. It was a multicenter, observational, non-interventional, prospective study.

Methods

Direct costs per patient in standard clinical practice were assessed for 6 months before and after the start of insulin therapy from the perspective of the Spanish health care system perspective. A total of 188 patients (42.6%women) with a mean age of 65.3 years, a mean body mass index of 29.7 kg/m², and a mean disease duration of 10.7 years were assessed.

Results

Before insulin therapy was started, mean (standard deviation) values of various clinical parameters were: hemoglobin A_1c (%), 9.22 (1.58); fasting plasma glucose (mmol/L), 12.03 (3.62); and total cholesterol (mmol/L), 4.90 (1.1). These values decreased after insulin therapy was started. Mean total direct health care costs per patient 6 months before and after insulin start were 鈧?39 and 鈧?,110, respectively. Mean total costs 6 months after insulin was started included costs of hospitalization (30.5%, 鈧?39), insulin (16.2%, 鈧?80), primary care (14.3%, 鈧?59), blood glucose monitoring (13.8%, 鈧?53), specialized care (13.3%, 鈧?48), oral antidiabetics (7.8%, 鈧?7), and other diabetes-related treatments (3.9%, 鈧?3).

Conclusions

The clinical outcomes of T2DM patients improved after insulin therapy was started. This improvement was associated to increases in resource utilization and direct health care costs in the first 6 months of insulin therapy.