Cost-Effectiveness of Gliclazide - Based Intensive Glucose Control

Worldwide, over 400 million individuals have diabetes; 90% of these have type 2 diabetes mellitus (T2DM). Asian populations appear to be at higher risk of developing T2DM than other ethnic groups. The prevalence of T2DM in Vietnam is increasing rapidly. This increase has consequently created a considerable and growing economic burden in Vietnam. Therefore, a clear need exists to reduce the economic impact of the disease.

Current diabetes guidelines recommend a target glycated hemoglobin level <7.0%; there is evidence that intensive glucose control (IGC) regimes may offer benefits to patients, particularly with regard to reducing the risk of microvascular complications. ADVANCE study was a global, randomized, controlled trial designed to assess the effects of IGC on major vascular outcomes in a broad cross-section of patients with T2DM.

The objective of this analysis is to assess the cost-effectiveness of IGC vs. SGC (standard glucose control) from a Vietnamese healthcare payer perspective, using clinical outcomes identified from the ADVANCE trial. Health outcomes were expressed in terms of ESRD avoided and quality-adjusted life years (QALYs). Costs (in US $) comprised treatment costs and health state costs.

Over a 5-year horizon, IGC avoided additional ESRD events compared with SGC and provided additional QALYs. In Vietnam, gliclazide-based IGC was shown to be cost-effective compared with SGC from a healthcare payer perspective, as defined in the ADVANCE study.

https://pubmed.ncbi.nlm.nih.gov/33194963/