ABSTRACT

Background: The aim of this study was to estimate the incremental cost-utility ratio (ICUR) of a multi-modal intervention in frail and pre-frail subjects aged ≥70 years with type-2 diabetes versus usual care group focused on quality adjusted life years (QALYs) in different European countries.

Methods: The MID-FRAIL study was a cluster randomized multicentre trial conducted in seven European countries. A cost-utility analysis was carried out based on this study, conducted from the perspective of the health care system with a time horizon of one year. Univariate and probabilistic analysis were carried out to test the robustness of the results.

Results: The cost estimation showed the offsetting health effect of the intervention program on total health care costs. The mean annual health care costs were 25% higher among patients in usual care. The mean incremental QALY gained per patient by the intervention group were 0.053 QALY compared with usual care practice.

Conclusions: The MID-FRAIL intervention program showed to be the dominant option in comparison with usual care practice. It saved costs to the health care system and achieved worthwhile health gains. This finding should encourage its implementation, at least, in the trial participant countries.

摘要

背景：本研究的目的是评估≥70岁的2型糖尿病虚弱和虚弱患者与常规护理组（注重质量调整生活）的多模式干预措施的增量成本-效用比率（ICUR）欧洲不同国家/地区（QALYs）。

方法：MID-FRAIL研究是在七个欧洲国家/地区进行的整群随机多中心试验。基于这项研究，从卫生保健系统的角度进行了成本－效用分析，时间范围为一年。进行单因素和概率分析以检验结果的稳健性。

结果：成本估算显示干预计划对总医疗保健成本的抵消性健康影响。在常规护理中，患者的平均年度医疗保健费用高出25％。与常规护理实践相比，干预组每位患者获得的平均QALY增量为0.053 QALY。

结论：与常规护理实践相比，MID-FRAIL干预计划被证明是主要选择。它节省了医疗保健系统的成本，并获得了可观的健康收益。这一发现至少应鼓励参与试验的国家实施这一发现。