Introduction To assess the cost-effectiveness of a multidisciplinary and comprehensive innovative diabetes care program (CAIPaDi) versus usual treatment in public health institutions. Research design and methods Using a cost-effectiveness analysis, we compared the CAIPaDi program versus usual treatment given in Mexican public health institutions. The analysis was based on the IQVIA Core Diabetes Model, a validated simulation model used to estimate long-term clinical outcomes. Data were prospectively obtained from the CAIPaDi program and from public databases and published papers. Health outcomes were expressed in terms of life-years gained and quality-adjusted life years (QALYs). Health and economic outcomes were estimated from a public perspective and discounted at 5% per year over a 20-year horizon. Costs are reported in US dollars (US$) of 2019. A probabilistic sensitivity analysis was performed using life-years gained and QALYs. Results The CAIPaDi costs on average US$559 (95% CI: −$879 to −$239) less than the usual treatment (95% CI: −$879 to −$239) and produced a difference in mean life-years gained (0.48, 95% CI: 0.45 to 0.52) and mean QALYs (1.43, 95% CI: 1.40 to 1.46). The cost-effectiveness ratio resulted in a saving per life-year gained of −US$1155 (95% CI: −$1962 to −$460). Mean differences in QALYs resulted in a saving per QALY of −US$735 (95% CI: −$1193 to −$305). Probabilistic sensitivity analysis proved the results are robust on both life-years gained and QALYs. Conclusions CAIPaDi has a better cost-effectiveness ratio than the usual therapy in Mexican public health institutions. All data relevant to the study are included in the article or uploaded as supplemental information.

中文翻译：

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在墨西哥城一家专科医院诊断长达 5 年的 2 型糖尿病患者进行自我管理和综合培训干预的成本效益

介绍 评估多学科综合创新糖尿病护理计划 (CAIPaDi) 与公共卫生机构中常规治疗的成本效益。研究设计和方法 通过成本效益分析，我们将 CAIPaDi 计划与墨西哥公共卫生机构提供的常规治疗进行了比较。该分析基于 IQVIA 核心糖尿病模型，这是一种经过验证的模拟模型，用于估计长期临床结果。数据是从 CAIPaDi 计划、公共数据库和已发表论文中前瞻性获得的。健康结果以获得的生命年和质量调整生命年 (QALY) 表示。健康和经济成果是从公众角度估计的，并在 20 年的范围内以每年 5% 的速度贴现。成本以 2019 年的美元 (US$) 报告。使用获得的生命年和 QALY 进行概率敏感性分析。结果 CAIPaDi 平均花费 559 美元（95% CI：-$879 至 -$239）比常规治疗（95% CI：-$879 至 -$239）少，并且平均寿命增加（0.48，95%） CI：0.45 至 0.52）和平均 QALY（1.43，95% CI：1.40 至 1.46）。成本效益比导致每生命年节省 -1155 美元（95% CI：-1962 至 -460 美元）。QALY 的平均差异导致每个 QALY 节省 - 735 美元（95% CI： - 1193 至 - 305 美元）。概率敏感性分析证明结果在获得的生命年数和 QALYs 上都是稳健的。结论 CAIPaDi比墨西哥公共卫生机构的常规治疗具有更好的成本效益比。