Improving outcomes with early and intensive metabolic control in patients with type 2 diabetes: a long-term modeling analysis of clinical and cost outcomes in Italy

Objectives: This analysis quantifies the potential long-term clinical and cost benefits of early and intensive metabolic control (EIMC) versus conventional management in patients newly diagnosed with type 2 diabetes in Italy. Methods: The PRIME T2D Model was used to project clinical and cost outcomes over long-term time horizons for a newly diagnosed cohort of patients receiving EIMC or conventional management. EIMC was associated with a mean glycated hemoglobin reduction of 0.6% from baseline and a mean weight loss of 9.5 kg (8.2%) for a duration of 6 years, before gradually returning to the same levels as the conventional management arm over 6 years. Modifiable risk factors were assumed to progress over time based on published regression functions. Direct and indirect costs associated with diabetes-related complications were accounted in 2021 Euros (EUR), with unit costs and health state utilities derived from published sources. Future costs and clinical benefits were discounted at 3% annually. Results: For the population diagnosed with type 2 diabetes in 2021 (estimated at 216,417 cases), EIMC was projected to add approximately 33,112 years of life and 55,403 quality-adjusted life years versus conventional management. Cost savings with EIMC were estimated at EUR 494 million, EUR 608 million and EUR 628 million in the incident population at 10- and 20- and 50-year time horizons, respectively. Conclusions: According to this modeling study, early and intensive metabolic control has the potential to substantially improve clinical outcomes and reduce economic burden compared with conventional management of patients with type 2 diabetes in Italy. Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-024-01553-w.