Modeling the Impact of Enhanced Treatment of Type 2 Diabetes Mellitus in Bulgaria

Abstract:

The objective of this study was to model and evaluate the consequences of an enhanced treatment of type 2 diabetes mellitus on cost, life expectancy and development of complications in the Bulgarian health care system. The extensively published and validated CORE Diabetes Model was used to perform lifetime simulations for the representative diabetic patient in Bulgaria diagnosed at 55 years. The analysis compared two alternative treatment scenarios with the current standards of care. In the first alternative scenario the model examined the human and economic costs of a 10% reduction in the risk factors for developing diabetes related complications. In the second scenario consequences of treating to targets set in American Diabetes Association (ADA) guidelines were simulated. The costs of treatment and complications were based on officially published sources for medicine prices, for hospital charges and verified by an expert opinion survey (1 BGN = 0,51 EUR). Treatment to targets postpones minor complications by up to 4 years, delays major complications by 3 to 4 years and extends life expectancy from diagnosis by 3 years compared with the baseline scenario. The total cost over remaining life expectancy from the diagnosis dropped from 2 483 BGN to 2 908 BGN per person.