November 2, 1999Annals of Internal Medicine
The Cost-Effectiveness of Treating All Patients with Type 2 Diabetes with Angiotensin-Converting Enzyme Inhibitors
Why the study?
Does treating all patients with type 2 diabetes with angiotensin-converting enzyme inhibitors improve quality-adjusted life expectancy and cost-effectiveness compared to screening strategies?
Population
Patients 50 years of age with newly diagnosed type 2 diabetes
Comparison
Angiotensin-converting enzyme inhibitors for all… vs Screening for microalbuminuria, or screening for…
Design
Other
Follow-up
Lifetime
Authors
Discussion
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Implication
May support universal ACE inhibitor use in type 2 diabetes as cost-effective; extends microalbuminuria efficacy data into economic modeling.
Structured PICO
Does treating all patients with type 2 diabetes with angiotensin-converting enzyme inhibitors improve quality-adjusted life expectancy and cost-effectiveness compared to screening strategies?
P
Population
Patients 50 years of age with newly diagnosed type 2 diabetes (fasting plasma glucose level >= 7.8 mmol/L [140 mg/dL])
I
Intervention
Angiotensin-converting enzyme inhibitors for all patients
C
Comparator
Screening for microalbuminuria, or screening for gross proteinuria
O
Outcome
Lifetime cost, quality-adjusted life expectancy, and marginal cost-effectiveness
Treating all middle-aged patients with type 2 diabetes with ACE inhibitors is a cost-effective strategy compared to screening for microalbuminuria, providing additional QALYs at a modest cost.
Limitations
- Results sensitive to cost, effectiveness, and quality of life associated with ACE inhibitor therapy
- Results sensitive to age at diagnosis
- Assumes patients meet older diagnostic criteria
- Assumes patients are not bothered by treatment
Cite This Study
Goláň et al. (1999) studied this question.