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• W2020462643 startingPage "89" @default.
• W2020462643 abstract "Background: Angiotensin-converting enzyme (ACE) inhibitors slow renal disease progression and reduce cardiac morbidity and mortality in patients with diabetes. Patients' out-of-pocket costs pose a barrier to using this effective therapy. Objective: To estimate the cost-effectiveness to Medicare of first-dollar coverage (no cost sharing) of ACE inhibitors for beneficiaries with diabetes. Design: Markov model with costs and benefits discounted at 3%. Data Sources: Published literature and Medicare claims data. Target Population: 65-year-old Medicare beneficiary with diabetes. Time Horizon: Lifetime. Perspective: Medicare and societal. Interventions: We evaluated Medicare first-dollar coverage of ACE inhibitors compared with current practice (no coverage) and the new Medicare drug benefit. Outcome Measures: Costs (2003 U.S. dollars), quality-adjusted life-years (QALYs), life-years, and incremental cost-effectiveness. Results of Base-Case Analysis: Compared with current practice, first-dollar coverage of ACE inhibitors saved both lives and money (0.23 QALYs gained and $1606 saved per Medicare beneficiary). Compared with the new Medicare drug benefit, first-dollar coverage remained a dominant strategy (0.15 QALYs gained, $922 saved). Results of Sensitivity Analysis: Results were most sensitive to our estimate of increase in ACE inhibitor use; however, if ACE inhibitor use increased by only 7.2% (from 40% to 47.2%), first-dollar coverage would remain life-saving at no net cost to Medicare. In analyses conducted from the societal perspective, benefits were similar and cost savings were larger. Limitations: Results depend on accuracy of the underlying data and assumptions. The effect of more generous drug coverage on medication adherence is uncertain. Conclusions: Medicare first-dollar coverage of ACE inhibitors for beneficiaries with diabetes appears to extend life and reduce Medicare program costs. A reduction in program costs may result in more money to spend on other health care needs of the elderly." @default.
• W2020462643 created "2016-06-24" @default.
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• W2020462643 date "2005-07-19" @default.
• W2020462643 modified "2023-09-28" @default.
• W2020462643 title "Cost-Effectiveness of Full Medicare Coverage of Angiotensin-Converting Enzyme Inhibitors for Beneficiaries with Diabetes" @default.
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• W2020462643 doi "https://doi.org/10.7326/0003-4819-143-2-200507190-00007" @default.
• W2020462643 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/16027450" @default.
• W2020462643 hasPublicationYear "2005" @default.
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