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• W2912753707 abstract "Hypoglycemia is one of the most common complications to achieve a good metabolic control, and has been listed by several scientific associations as a common indication to start treatment with continuous subcutaneous insulin infusion (CSII). Use of CSII is still residual in Spain as compared to neighboring countries, and cost of acquisition cost is one of the main reasons.This study estimates the budget impact of treatment with CSII, as compared to multiple daily insulin injections, of patients with type 1 diabetes mellitus who experience recurrent severe hypoglycemia episodes from the National Healthcare System perspective.Budget impact was based on a retrospective, observational study evaluating the efficacy of CSII in patients with type 1 diabetes mellitus conducted at Hospital Clínic i Universitari in Barcelona, where one of the main indications for switching to CSII were recurrent severe hypoglycemia episodes. The mean number of annual episodes was 1.33 in the two years prior to CSII start and 0.08 in the last two years of follow up (p = 0.003). Costs of treatment and major hypoglycemic events over a four-year period were considered. Costs were taken from different Spanish data sources and expressed in € of 2016.Treatment with CSII increased costs by €9509 per patient as compared to multiple daily insulin injections (€11,902–€2393). Cost associated to severe hypoglycemic events decreased by €19,330 per patient treated with CSIII (€1371–€20,701). Results suggest mean total savings of €9821 per patient during the four-year study period.The higher costs associated to CSII therapy may be totally offset by the severe hypoglycemic events prevented.Las hipoglucemias suponen una de las complicaciones más habituales para alcanzar un buen control metabólico y figuran entre las indicaciones comúnmente aceptadas por diferentes sociedades para iniciar tratamiento con infusión subcutánea continua de insulina (ISCI). La utilización de ISCI en España es aún residual en comparación con países de nuestro entorno, siendo el coste de adquisición una de las principales motivaciones.Este trabajo estima el impacto presupuestario asociado a ISCI frente a múltiples dosis de insulina en pacientes con diabetes mellitus tipo 1 e hipoglucemias graves recurrentes desde la perspectiva del Sistema Nacional de Salud.El impacto presupuestario está basado en los resultados de un estudio observacional que evaluó la efectividad de ISCI en el Hospital Clínic i Universitari de Barcelona, donde el promedio anual de hipoglucemias graves en los dos años anteriores al inicio con ISCI fue 1,33 y 0,08 en los últimos dos años de seguimiento (p = 0,003). Se contemplaron los costes asociados al tratamiento y al manejo de hipoglucemias graves durante cuatro años. Los costes unitarios (€, 2016) fueron obtenidos de bases de datos nacionales.El coste del tratamiento con ISCI resultó en un incremento de 9.509€/paciente frente a múltiples dosis de insulina (11.902€-2.393€). El coste asociado a las hipoglucemias graves disminuyó 19.330€/paciente en aquellos tratados con ISCI (1.371€-20.701€). Los resultados indican un ahorro medio de 9.821€/paciente para el SNS en los cuatro años de estudio.El incremento asociado al coste del tratamiento podría quedar totalmente compensado gracias a los episodios de hipoglucemia grave evitados." @default.
• W2912753707 created "2019-02-21" @default.
• W2912753707 creator A5076187185 @default.
• W2912753707 date "2017-08-01" @default.
• W2912753707 modified "2023-09-26" @default.
• W2912753707 title "Limitations of current thyroid function tests" @default.
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• W2912753707 doi "https://doi.org/10.1016/j.endien.2017.08.013" @default.
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