IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0026139.html
   My bibliography  Save this article

Cost-Effectiveness of Angiotensin-Converting Enzyme Inhibitors for the Prevention of Diabetic Nephropathy in The Netherlands – A Markov Model

Author

Listed:
  • Charles Christian Adarkwah
  • Afschin Gandjour
  • Maren Akkerman
  • Silvia M Evers

Abstract

Objective: Type 2 diabetes is the main cause of end-stage renal disease (ESRD) in Europe and the USA. Angiotensin-converting enzyme (ACE) inhibitors have a potential to slow down the progression of renal disease and therefore provide a renal-protective effect. The aim of our study was to assess the most cost-effective time to start an ACE inhibitor (or an angiotensin II receptor blocker [ARB] if coughing as a side effect occurs) in patients with newly diagnosed type 2 diabetes in The Netherlands. Methods: A lifetime Markov decision model with simulated 50-year-old patients with newly diagnosed diabetes mellitus was developed using published data on costs and health outcomes and simulating the progression of renal disease. A health insurance perspective was adopted. Three strategies were compared: treating all patients at the time of diagnosing type 2 diabetes, screening for microalbuminuria, and screening for macroalbuminuria. Results: In the base-case analysis, the treat-all strategy is associated with the lowest costs and highest benefit and therefore dominates screening both for macroalbuminuria and microalbuminuria. A multivariate sensitivity analysis shows that the probability of savings is 70%. Conclusions: In The Netherlands for patients with type 2 diabetes prescription of an ACE inhibitor immediately after diagnosis should be considered if they do not have contraindications. An ARB should be considered for those patients developing a dry cough under ACE inhibitor therapy. The potential for cost savings would be even larger if the prevention of cardiovascular events were considered.

Suggested Citation

  • Charles Christian Adarkwah & Afschin Gandjour & Maren Akkerman & Silvia M Evers, 2011. "Cost-Effectiveness of Angiotensin-Converting Enzyme Inhibitors for the Prevention of Diabetic Nephropathy in The Netherlands – A Markov Model," PLOS ONE, Public Library of Science, vol. 6(10), pages 1-10, October.
    • Handle: RePEc:plo:pone00:0026139
    DOI: 10.1371/journal.pone.0026139
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0026139
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0026139&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0026139?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. van Os, Nicole & Niessen, Louis W. & Bilo, Henk J. G. & Casparie, Anton F. & van Hout, Ben A., 2000. "Diabetes nephropathy in the Netherlands: a cost effectiveness analysis of national clinical guidelines," Health Policy, Elsevier, vol. 51(3), pages 135-147, April.
    2. Andrew H. Briggs & A. E. Ades & Martin J. Price, 2003. "Probabilistic Sensitivity Analysis for Decision Trees with Multiple Branches: Use of the Dirichlet Distribution in a Bayesian Framework," Medical Decision Making, , vol. 23(4), pages 341-350, July.
    3. de Wit, G.Ardine & Ramsteijn, Paul G & de Charro, Frank Th, 1998. "Economic evaluation of end stage renal disease treatment," Health Policy, Elsevier, vol. 44(3), pages 215-232, June.
    4. Peeters, Pascale & Rublee, Dale & Just, Paul M. & Joseph, Alain, 2000. "Analysis and interpretation of cost data in dialysis: review of Western European literature," Health Policy, Elsevier, vol. 54(3), pages 209-227, December.
    5. Bleichrodt, Han & Johannesson, Magnus, 1997. "Standard gamble, time trade-off and rating scale: Experimental results on the ranking properties of QALYs," Journal of Health Economics, Elsevier, vol. 16(2), pages 155-175, April.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Kontodimopoulos, Nick & Niakas, Dimitris, 2008. "An estimate of lifelong costs and QALYs in renal replacement therapy based on patients' life expectancy," Health Policy, Elsevier, vol. 86(1), pages 85-96, April.
    2. Just, Paul Michael & Riella, Miguel Carlos & Tschosik, Elizabeth Ann & Noe, Leslie Lyle & Bhattacharyya, Samir Kumar & de Charro, Frank, 2008. "Economic evaluations of dialysis treatment modalities," Health Policy, Elsevier, vol. 86(2-3), pages 163-180, May.
    3. Alexander V van Schoonhoven & Judith J Gout-Zwart & Marijke J S de Vries & Antoinette D I van Asselt & Evgeni Dvortsin & Pepijn Vemer & Job F M van Boven & Maarten J Postma, 2019. "Costs of clinical events in type 2 diabetes mellitus patients in the Netherlands: A systematic review," PLOS ONE, Public Library of Science, vol. 14(9), pages 1-22, September.
    4. Alan Brennan & Samer Kharroubi & Anthony O'Hagan & Jim Chilcott, 2007. "Calculating Partial Expected Value of Perfect Information via Monte Carlo Sampling Algorithms," Medical Decision Making, , vol. 27(4), pages 448-470, July.
    5. Rachael DiSantostefano & Andrea Biddle & John Lavelle, 2006. "The Long-Term Cost Effectiveness of Treatments for Benign Prostatic Hyperplasia," PharmacoEconomics, Springer, vol. 24(2), pages 171-191, February.
    6. Nick Bansback & Roberta Ara & Sue Ward & Aslam Anis & Hyon Choi, 2009. "Statin Therapy in Rheumatoid Arthritis," PharmacoEconomics, Springer, vol. 27(1), pages 25-37, January.
    7. Stefan A. Lipman & Werner B. F. Brouwer & Arthur E. Attema, 2020. "What is it going to be, TTO or SG? A direct test of the validity of health state valuation," Health Economics, John Wiley & Sons, Ltd., vol. 29(11), pages 1475-1481, November.
    8. Attema, Arthur E. & Brouwer, Werner B.F., 2009. "The correction of TTO-scores for utility curvature using a risk-free utility elicitation method," Journal of Health Economics, Elsevier, vol. 28(1), pages 234-243, January.
    9. José‐Luis Pinto‐Prades & José‐María Abellán‐Perpiñán, 2005. "Measuring the health of populations: the veil of ignorance approach," Health Economics, John Wiley & Sons, Ltd., vol. 14(1), pages 69-82, January.
    10. Paul Dolan & Daniel Kahneman, 2008. "Interpretations Of Utility And Their Implications For The Valuation Of Health," Economic Journal, Royal Economic Society, vol. 118(525), pages 215-234, January.
    11. Anne‐Laure Samson & Erik Schokkaert & Clémence Thébaut & Brigitte Dormont & Marc Fleurbaey & Stéphane Luchini & Carine Van de Voorde, 2018. "Fairness in cost‐benefit analysis: A methodology for health technology assessment," Health Economics, John Wiley & Sons, Ltd., vol. 27(1), pages 102-114, January.
    12. Olsen, Jan Abel & Donaldson, Cam & Shackley, Phil, 2005. "Implicit versus explicit ranking: On inferring ordinal preferences for health care programmes based on differences in willingness-to-pay," Journal of Health Economics, Elsevier, vol. 24(5), pages 990-996, September.
    13. Andrija S Grustam & Nasuh Buyukkaramikli & Ron Koymans & Hubertus J M Vrijhoef & Johan L Severens, 2019. "Value of information analysis in telehealth for chronic heart failure management," PLOS ONE, Public Library of Science, vol. 14(6), pages 1-23, June.
    14. Henrik Andersson & James K. Hammitt & Kristian Sundström, 2015. "Willingness to Pay and QALYs: What Can We Learn about Valuing Foodborne Risk?," Journal of Agricultural Economics, Wiley Blackwell, vol. 66(3), pages 727-752, September.
    15. Arthur E. Attema & Han Bleichrodt & Olivier l’Haridon & Stefan A. Lipman, 2020. "A comparison of individual and collective decision making for standard gamble and time trade-off," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(3), pages 465-473, April.
    16. Polak, B. C. P. & Crijns, H. & Casparie, A. F. & Niessen, L. W., 2003. "Cost-effectiveness of glycemic control and ophthalmological care in diabetic retinopathy," Health Policy, Elsevier, vol. 64(1), pages 89-97, April.
    17. Thomas W Ferguson & James Zacharias & Simon R Walker & David Collister & Claudio Rigatto & Navdeep Tangri & Paul Komenda, 2015. "An Economic Assessment Model of Rural and Remote Satellite Hemodialysis Units," PLOS ONE, Public Library of Science, vol. 10(8), pages 1-11, August.
    18. Arthur Attema & Werner Brouwer, 2012. "The way that you do it? An elaborate test of procedural invariance of TTO, using a choice-based design," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(4), pages 491-500, August.
    19. Afiatin & Levina Chandra Khoe & Erna Kristin & Lusiana Siti Masytoh & Eva Herlinawaty & Pitsaphun Werayingyong & Mardiati Nadjib & Sudigdo Sastroasmoro & Yot Teerawattananon, 2017. "Economic evaluation of policy options for dialysis in end-stage renal disease patients under the universal health coverage in Indonesia," PLOS ONE, Public Library of Science, vol. 12(5), pages 1-10, May.
    20. Arthur E. Attema & Werner B.F. Brouwer, 2014. "Deriving Time Discounting Correction Factors For Tto Tariffs," Health Economics, John Wiley & Sons, Ltd., vol. 23(4), pages 410-425, April.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0026139. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.