"We tried to analyze what the health impact would be of achieving certain treatment targets for risk factors at the population level," explains Prof. Laxy, who holds the Chair of Public Health and Prevention at the Technical University of Munich. "The end parameter we looked at is quality-adjusted life span. This is composed of the quality of life and the lifespan of individuals. In addition, we calculated what economic implications a guideline-based setting would have within the health care system in terms of costs for outpatient and inpatient care, medication, etc." For this purpose, health outcomes and costs in the healthcare system of people with type 2 diabetes in Germany were projected over the periods of five, ten, and 30 years using the UK Prospective Diabetes Study Outcome Model 2 (UKPDS-OM2).
Health benefits and reduction in expenditure
The researchers found that sustained achievement of a target value of below 7% for HbA1c, below 140 mmHg for systolic blood pressure, and below ≤2.6 mmol/l for LDL cholesterol for all persons with type 2 diabetes in Germany would lead to substantial cost savings and gains in quality-adjusted lifetime. On a national level, this could reduce care costs by more than 1.9 billion euros over a ten-year period. In this respect, sustainable improvements in diabetes patients in Germany would lead to substantial health benefits and significantly reduce health care expenditures.
Health economic modeling
"This is health economic modeling with certain assumptions," says Prof. Laxy, putting the results into perspective. "If I want to provide better care for the affected individuals in the first place, which can lead to cost savings in the long term, more resources must of course be used for therapy and management. We didn't account for these investments for better or more intensive prevention and care in our study."
The expected long-term health and economic benefits analyzed in the course of the study can now help German decision-makers in the next step to evaluate interventions and therapy options from the point of view of efficiency.
Min Fan, Anna-Janina Stephan, Karl Emmert-Fees, Annette Peters, Michael Laxy: Health and economic impact of improved glucose, blood pressure and lipid control among German adults with type 2 diabetes: a Modeling Study. Diabetologia 2023. doi.org/10.1007/s00125-023-05950-3