Abstract

Background: This study aimed to estimate the expected cost of hypoglycaemia in Diabetes Mellitus type-2 patients receiving hypoglycaemic treatment in Chile and to explore the effect of the potential reduction of hypoglycaemia over the total cost incurred by its public health system.

Research design and methods: A cost analysis was carried out based on a state transition mathematical model. The model used microsimulation with data from the National Health Survey 2016-2017 in Chile. Costs included follow-up, in-hospital and ambulatory care. The model was validated by contrasting the outputs of incidence of severe and non-severe hypoglycaemia with data from the literature. Separate analysis was conducted for patients treated with insulin, or sulfonylurea.

Results: The annual expected total cost of hypoglycaemia estimated for the Chilean public system was USD 288,922,523 (USD 273 per patient). The subgroup treated with insulin reached USD 353 per patient whereas the sulfonylurea subgroup was USD 217 per patient. The analysis revealed that for every 1% reduction of the incidence rate of severe hypoglycaemia the cost is reduced 0.79% in total, 0.59% for the insulin subgroup and 0.95% for the sulfonylurea subgroup.

Conclusions: The cost of hypoglycaemia represents a high proportion of the public health budget in Chile, being similar to those resources allocated to provide coverage of diabetic treatments through its universal health benefit plan.

摘要

背景：本研究旨在评估智利接受降血糖治疗的2型糖尿病患者的低血糖预期成本，并探讨降低低血糖的可能性对其公共卫生系统总成本的影响。

研究设计和方法：基于状态转移数学模型进行了成本分析。该模型将微模拟与智利2016-2017年国家健康调查的数据结合使用。费用包括随访，住院和门诊护理。通过将重度和非重度低血糖的发生率输出与文献数据进行对比，验证了该模型的有效性。对接受胰岛素或磺脲类药物治疗的患者进行了单独分析。

结果：智利公共系统低血糖症的年度预期总费用估计为288,922,523美元（每位患者273美元）。胰岛素治疗的亚组每位患者达到353美元，而磺酰脲亚组的每位患者达到217美元。分析显示，严重低血糖发生率每降低1％，总成本降低0.79％，胰岛素亚组降低0.59％，磺酰脲亚组降低0.95％。

结论：低血糖症的费用在智利的公共卫生预算中所占比例很高，与通过其全民健康福利计划分配用于提供糖尿病治疗的资源相似。