Cost-Analysis of Intensified Multifactorial Treatment for Type 2 Diabetes

Introduction to Diabetes Complications

Researchers have conducted a cost-analysis comparing intensified multifactorial treatment to conventional methods for managing type 2 diabetes. Patients with this condition are at a heightened risk of developing severe complications affecting the eyes, kidneys, nerves, legs, and brain. These complications can be life-threatening, contributing to increased mortality rates among diabetic patients. However, many of these issues can be mitigated through careful screening and the application of multifactorial therapies.

The Steno-2 Study

In 1993, a research team initiated the Steno-2 Study to assess whether targeted multifactorial treatment could influence the overall mortality rates associated with type 2 diabetes. The study involved 160 Danish participants with an average age of 55, who were randomly divided into two groups. One group of 80 patients received the conventional multifactorial treatment, aligned with the recommendations of the Danish Medical Association, while the other group of 80 patients underwent intensified multifactorial treatment.

Intensified Multifactorial Treatment Approach

The intensified treatment group was targeted on improving all adjustable risk factors, including blood glucose, blood pressure, total cholesterol, and triglycerides, with more stringent target levels than those set for the conventional treatment group. This approach emphasized the use of multiple medications targeting various disease pathways, alongside enhancements in health through nutrition, exercise, and smoking cessation.

Study Findings and Follow-Up Results

The findings from this study were revealed in a press release by the American Diabetes Association during their convention in June 2018. The follow-up period spanned over 21 years. Results indicated that the intensified treatment group experienced nearly a 50% reduction in diabetes-related damage to the heart, brain, and legs after 7.8 years of treatment compared to their conventional counterparts.

After an observational follow-up of an average of 5.5 years, all participants transitioned to the intensified treatment. By the 13.3-year mark, the group originally assigned to intensified treatment displayed a 50% reduction in mortality, which extended to an increased lifespan of 7.9 years after 21.2 years.

Cost Analysis of Treatment Options

Interestingly, researchers reported no significant differences in direct medical costs between the intensified and conventional treatment groups over the 21.2-year follow-up. While initial costs may rise with intensified treatment, the investment is justified by the health benefits and increased longevity for patients.

Lead author Joachim Gaede emphasized in the American Diabetes Association press release that “investing in early-intensified intervention…will pay for itself over time due to a reduced cost of complications incurred by patients.” Total costs for the intensified treatment group amounted to $13 million, in contrast to $12.3 million for the conventional treatment group.

Conclusion

The researchers concluded that after an average follow-up of 21.2 years, there were no notable differences in total costs or cost per patient between intensified multifactorial treatment and conventional approaches over a 7.8-year span. Furthermore, patients receiving intensified treatment not only achieved significant health benefits but also enjoyed increased longevity compared to those undergoing conventional treatment.

Reference

American Diabetes Association. (2018). Intense Multifactorial Treatment for Type 2 Diabetes Shown to be Cost Effective. [online] Available at: http://www.diabetes.org/newsroom/press-releases/2018/intense-multifactorial-treatment-for-type-2-diabetes-shown-to-be-cost-effective.html [Accessed 12 Sep. 2018].