经济评估英格兰NHS的2型糖尿病治疗途径到缓解试点计划:来自现实世界的数据和患者模拟建模的证据
Adam Martin1,2, Tayamika Zabula3,4, Davide Tebaldi1,2
1Academic Unit of Health Economics, School of Medicine, University of Leeds, Worsley Building, Leeds, England, LS2 9TJ, UK.
PharmacoEconomics - open
|December 18, 2025
概括
对于英格兰NHS来说,如果减肥持续6-7年,那么2型糖尿病缓解途径 (T2DPR) 试点项目是具有成本效益的. 全国范围的推广对预算有重大影响,成本取决于吸收和长期缓解的成功.
科学领域:
- 卫生经济学 卫生经济学
- 公共卫生干预 公共卫生干预
- 糖尿病管理 糖尿病管理
背景情况:
- 英国NHS的"2型糖尿病缓解途径" (T2DPR) 计划提供低热量饮食,并为最近的2型糖尿病 (T2D) 诊断提供支持.
- 之前的试验表明干预成本很高,这引发了对金钱的价值和现实世界的有效性的问题.
研究的目的:
- 从英格兰NHS和服务用户的角度对T2DPR试点进行经济评估.
- 评估可能在全国范围内推出T2DPR的预算影响.
主要方法:
- 使用UKPDS结果模型v.2.2进行成本效益分析,采用来自838名T2DPR试点参与者的现实数据.
- 生命周期时间视界分析,将干预与反事实情景进行比较.
- 基于T2D发病率和肥胖患病率数据的全国预算影响估计.
主要成果:
- 如果体重和HbA1c的改善持续6-7年,T2DPR试点的成本效益为20,000英/QALY.
- 全国范围的推广可能会使英格兰NHS每年损失610万英 (10%的吸收) 至超过2000万英 (三分之一的吸收).
- 服务用户承担了自付费用,可能会被杂货储蓄所抵消.
结论:
- 由于需求很高,全国T2DPR实施带来了大量的预算和机会成本.
- 长期的成本效益取决于持续的体重和干预后的HbA1c降低.
- 需要进一步研究释放后的恢复轨迹和潜在的不平等.
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