Abstract
Amaç: Çalışmamızın amacı; bir yıllık süre
içerisinde takip ettiğimiz tip 2 diyabetik hastaların tedavi, tetkik ve muayene
için harcanan maliyetlerini ortaya koyup, bu maliyetlerin bir yıllık kontrolde
ne kadar etkili olduğunu göstermektir.
Gereç ve Yöntem: Son bir yıl içinde Tip 2
Diyabet tanısı ile polikliniğimizde ayaktan takip edilen 500 hasta çalışmaya alındı.
HbA1c (%) değerlerine göre ‘iyi regüle ≤7’, ‘kötü regüle7-10’, ‘çok kötü regüle
≥10’ olmak üzere 3 gruba ayrıldı ve üç grubun ortalama yıllık tedavi, muayene
ve tahlil maliyetleri hesaplanarak karşılaştırmaları yapıldı.
Bulgular: Son bir yıldır poliklinikte takip
edilen 500 Tip 2 Diyabet tanısı olan hastanın bir yıllık ilaç maliyeti
ortalaması kişi başı 1614 TL, ortalama muayene ve tahlil maliyeti ise 250 TL
olarak hesaplandı. HbA1c ≤7 olan
hastalarda bir yıllık ortalama tedavi maliyeti 835 TL, HbA1c 7-10 arasında olan
hastalarda 1879 TL iken, HbA1c ≥10 olan hastalarda ise 2182 TL saptandı. Sadece
oral antidiyabetik (OAD) kullanan grubun bir yıllık ortalama ilaç maliyeti 449
TL iken bu değer insülin kullanan grupta: 2429 TL ve OAD+insülin grubunda ise
2376 TL saptandı.
Sonuç: Tedavi maliyetleri açısından
değerlendirildiğinde iyi kontrollü diyabetik hastaların tedavi maliyetleri,
kötü kontrollü hastalardan anlamlı olarak daha düşük iken, iki grup arasında
muayene ve tahlil harcamalarında anlamlı fark saptanmadı. OAD kullanan grup ile
insülin ve OAD+insülin kullanan gruplar karşılaştırıldığında, OAD kullanan
grubun tedavi maliyeti diğer iki grubun maliyetinden anlamlı olarak düşük
tespit edildi. Yaş ve cinsiyet ile diyabet ilaç maliyeti arasında korelasyon
yokken, diyabet yaşı ile tedavi maliyeti arasında istatiksel olarak anlamlı
korelasyon saptandı.
References
- 1. King H, Rewers M. Global estimates for prevalence of diabetes mellitus and imparied glucose tolerance in adults. WHO Ad Hoc Diabetes Reporting Group. Diabetes Care 1993;16(1):157-77.
- 2. Zhang P, Zhang X, Brown J, Vistisen D, Sicree R, Shaw J, et al. Diabetes Atlas- Global health care expenditure on diabetes for 2010 and 2030. Diabetes Res Clin Pract 2010;87(3):293-301.
- 3. Jönsson B. Revealing the cost of Type 2 diabetes in Europe. Diabetologia 2002;45(7):S5-12.
- 4. Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag N, et al. TURDEP-II Study Group. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol 2013;28(2):169-80.
- 5. International Diabetes Federation, Diabetes Atlas, İnternational Diabetes Federation, Brussels, 3rd ed., 2006.
- 6. Malhan S, Öksüz E, Babineaux MS, Ertekin A, Palmer PJ. Assessment of the direct medical costs of the type 2 diabetes mellitus and its complications in Turkey. Turk J Endocrinol Metab 2014;18(2):39-43.
Abstract
Objective: The purpose of this study is to
estimate the cost-effectiveness of screening, treatment, and examination of
patients with type 2 diabetes during a yearly period and expose its importance
in diabetes control.
Materials and Methods: Five hundred
patients with type 2 diabetes who had received outpatient therapy in the past
year were enrolled in the study. Patients were divided into three categories
according to their hemoglobin A1c (HbA1c) (%) levels: good control (HbA1c
<7%), fair control (HbA1c 7%–10%), and poor control (HbA1c >10%). Average
annual costs of treatment, examination, and laboratory workup were compared for
the three groups.
Results: The average annual cost of
medication for 500 type 2 diabetes patients was $556.50, while the cost of
screening and examination was $89.20 per patient. The average yearly treatment
cost per patient was $287.90 for patients with HbA1c ≤7%, $647.90 for patients
with HbA1c 7%–10%, and $752.40 patients with HbA1c ≥10%. The average annual
costs of treatment with only oral anti-diabetic drugs (OAD), insulin only, and
both OAD and insulin were $154.80, $837.50, and $819.30, respectively.
Conclusion: While the cost to treat
diabetic patients with good control was significantly lower than the treatment
cost of patients with poor control, there was no significant difference in
laboratory workup and examination costs. When patients treated with OAD only,
insulin only and OAD + insulin were compared, treatment costs for the OAD only
group were significantly lower than the costs to treat the insulin only and OAD
+ insulin groups. No correlation between age or sex and medication cost were
found. However, a strong correlation was found between diabetes duration and
treatment cost.
References
- 1. King H, Rewers M. Global estimates for prevalence of diabetes mellitus and imparied glucose tolerance in adults. WHO Ad Hoc Diabetes Reporting Group. Diabetes Care 1993;16(1):157-77.
- 2. Zhang P, Zhang X, Brown J, Vistisen D, Sicree R, Shaw J, et al. Diabetes Atlas- Global health care expenditure on diabetes for 2010 and 2030. Diabetes Res Clin Pract 2010;87(3):293-301.
- 3. Jönsson B. Revealing the cost of Type 2 diabetes in Europe. Diabetologia 2002;45(7):S5-12.
- 4. Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag N, et al. TURDEP-II Study Group. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol 2013;28(2):169-80.
- 5. International Diabetes Federation, Diabetes Atlas, İnternational Diabetes Federation, Brussels, 3rd ed., 2006.
- 6. Malhan S, Öksüz E, Babineaux MS, Ertekin A, Palmer PJ. Assessment of the direct medical costs of the type 2 diabetes mellitus and its complications in Turkey. Turk J Endocrinol Metab 2014;18(2):39-43.
Details
| Journal Section | Clinical Research |
|---|---|
| Authors | |
| Publication Date | September 1, 2017 |
| Submission Date | December 1, 2016 |
| Published in Issue | Year 2017 Volume: 80 Issue: 3 |
Cite
Contact information and address
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Email: itfdergisi@istanbul.edu.tr
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