Cost-effectiveness analysis of nephroprotection programs for patients with type 2 diabetes mellitus in insurers in Colombia.

IF 1.7 4区医学 Q3 HEALTH POLICY & SERVICES

Cost Effectiveness and Resource Allocation Pub Date : 2025-04-12 DOI:10.1186/s12962-025-00618-8

Cristian Alejandro González-Rojas, Sergio Augusto Cáceres-Maldonado, Luis Alberto Soler-Vanoy, Lizbeth Alexandra Acuña-Merchán

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Abstract

Background: This research aimed to determine the cost-effectiveness of nephroprotection programs compared to no intervention in adults with type 2 diabetes mellitus (T2DM) in the Colombian national health system.

Methods: A Markov analysis with 3 disease states (controlled, uncontrolled and death) was modeled using a 1-year cycle and a 10-year time horizon based on T2DM and chronic kidney disease (CKD) data in Colombia from 2020 to 2023 from the perspective of the health insurance system. Effectiveness was considered as the control of CKD progression, with a decrease of estimated glomerular filtration rate (eGFR using CKD-EPI) of less than 5 ml/min/1.73 m², and glycated hemoglobin (HBA1c) of less than or equal to 7%. Costs are expressed in 2023 $USD. Univariate and multivariate probabilistic sensitivity analyses were conducted using 1,000 Monte Carlo simulations.

Results: Compared to no intervention, nephroprotection programs were found to be cost-effective, with a dominant incremental cost-effectiveness ratio (ICER). Furthermore, the sensitivity analysis results showed that having a nephroprotection program is a cost-effective strategy in 89.2% and dominant in 56.7% of the simulations.

Conclusions: Nephroprotection programs result in better T2DM control and slower CKD progression, while also being lower in costs incurred during the year.

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哥伦比亚保险公司2型糖尿病患者肾保护项目的成本-效果分析

背景：本研究旨在确定哥伦比亚国家卫生系统中成人2型糖尿病（T2DM）患者肾保护计划与不干预相比的成本效益。方法：以哥伦比亚2020 - 2023年T2DM和慢性肾脏疾病（CKD）数据为基础，从健康保险制度的角度，采用1年周期和10年时间范围，对3种疾病状态（控制、未控制和死亡）进行马尔可夫分析。有效性被认为是CKD进展的控制，估计肾小球滤过率（使用CKD- epi的eGFR）降低小于5 ml/min/1.73 m2，糖化血红蛋白（HBA1c）小于或等于7%。成本以2023年美元表示。使用1000个蒙特卡罗模拟进行单变量和多变量概率敏感性分析。结果：与不进行干预相比，肾保护方案具有成本效益，其增量成本-效果比（ICER）占主导地位。此外，敏感性分析结果显示，在89.2%的模拟中，肾保护计划是一种具有成本效益的策略，在56.7%的模拟中占主导地位。结论：肾保护项目可以更好地控制T2DM，减缓CKD的进展，同时降低全年的费用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cost Effectiveness and Resource Allocation HEALTH POLICY & SERVICES-

CiteScore

3.40

自引率

4.30%

发文量

审稿时长

34 weeks

期刊介绍： Cost Effectiveness and Resource Allocation is an Open Access, peer-reviewed, online journal that considers manuscripts on all aspects of cost-effectiveness analysis, including conceptual or methodological work, economic evaluations, and policy analysis related to resource allocation at a national or international level. Cost Effectiveness and Resource Allocation is aimed at health economists, health services researchers, and policy-makers with an interest in enhancing the flow and transfer of knowledge relating to efficiency in the health sector. Manuscripts are encouraged from researchers based in low- and middle-income countries, with a view to increasing the international economic evidence base for health.