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Laxy M, Becker J, Kähm K, Holle R, Peters A, Thorand B, Schwettmann L, Karl FM. Utility Decrements Associated With Diabetes and Related Complications: Estimates From a Population-Based Study in Germany. Value Health 2021; 24:274-280. [PMID: 33518034 DOI: 10.1016/j.jval.2020.09.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 08/24/2020] [Accepted: 09/29/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Health utility decrement estimates for diabetes and complications are needed for parametrization of simulation models that aim to assess the cost-utility of diabetes prevention and care strategies. This study estimates health utility decrements associated with diabetes and cardiovascular and microvascular complications from a population-based German study. METHODS Data were obtained from the population based cross-sectional KORA (Cooperative Health Research in the Augsburg Region) health questionnaire 2016 and comprised n = 1072 individuals with type 2 diabetes and n = 7879 individuals without diabetes. Health utility was assessed through the EQ-5D-5L. We used linear regression models with interaction terms between type 2 diabetes and different cardiovascular and microvascular complications while adjusting for demographic and socio-economic factors and other comorbidities. RESULTS Type 2 diabetes (β = -0.028, standard error [SE] = 0.014), stroke (β = -0.070, SE = 0.010), cardiac arrhythmia (β = -0.031, SE = 0.006), heart failure (β = -0.073, SE = 0.009), coronary heart disease (β = -0.028, SE = 0.010), myocardial infarction (β = -0.020, SE = 0.011, estimates of main effect), and neuropathy (β = -0.067, SE = 0.020), diabetic foot (β = -0.042, SE = 0.030), nephropathy (β = -0.032, SE = 0.025), and blindness (β = -0.094, SE = 0.056, estimates of interaction terms) were negatively associated with health utility. The interaction term for diabetes x stroke (β = -0.052, SE = 0.021) showed that the utility decrement for stroke is significantly larger in people with type 2 diabetes than in people without diabetes. CONCLUSIONS Diabetes, cardiovascular, and microvascular conditions are associated with significant health utility decrements. Utility decrements for some conditions differ between people with and without type 2 diabetes. These results are of high relevance for the parametrization of decision analytic simulation models and applied health economic evaluations in the field of prevention and management of type 2 diabetes in Germany.
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Affiliation(s)
- Michael Laxy
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany; Institute of Health Economics and Healthcare Management, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany; German Centre for Diabetes Research (DZD), Neuherberg, Germany; Global Diabetes Research Center, Rollins School of Public Health, Emory University, Atlanta, GA.
| | - Jana Becker
- Institute of Health Economics and Healthcare Management, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany; Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, WHO Collaborating Centre for Occupational Health, University Hospital Munich, Munich, Germany
| | - Katharina Kähm
- Institute of Health Economics and Healthcare Management, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany; German Centre for Diabetes Research (DZD), Neuherberg, Germany
| | - Rolf Holle
- Institute of Health Economics and Healthcare Management, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany; German Centre for Diabetes Research (DZD), Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Ludwig-Maximilians-University Munich, Munich, Germany
| | - Annette Peters
- German Centre for Diabetes Research (DZD), Neuherberg, Germany; Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Barbara Thorand
- German Centre for Diabetes Research (DZD), Neuherberg, Germany; Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Lars Schwettmann
- Institute of Health Economics and Healthcare Management, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany; Department of Economics, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Florian M Karl
- Institute of Health Economics and Healthcare Management, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany; German Centre for Diabetes Research (DZD), Neuherberg, Germany
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