Implementing intensive control of blood glucose concentration and blood pressure in type 2 diabetes in England: cost analysis (UKPDS 63)

Abstract

Objective: To estimate the incremental cost of implementing policies for intensive control of blood glucose concentration and blood pressure for all patients with type 2 diabetes in England.

Design: Extrapolation of resource use and cost data derived from a randomised controlled trial.

Setting: General practice, outpatient care, and inpatient care.

Population: Trial population with diagnosed type 2 diabetes in England extrapolated to the population of England.

Main outcome measures: Total costs based on use of healthcare resources including costs of management, treatment, and hospitalisation.

Results: The incremental net annual cost of implementing intensive control of blood glucose and blood pressure to all people with diagnosed type 2 diabetes in England is estimated to be pound 100.5m ($156m; euro;159m), which is equivalent to less than 1% of the proposed additional annual expenditure on the NHS in 2001-5. This estimate varied in sensitivity analyses from pound 67m to pound 121m.

Conclusions: Policies to improve control of blood glucose and blood pressure of people with type 2 diabetes are effective in reducing complications associated with the disease and are also cost effective. The total cost represents a small fraction of the NHS's spending plans.

Figures

Figure 1

Estimated additional management costs (£m, at 1999 prices) of adopting policies in England for intensive control of blood glucose and blood pressure by category of resource use (total=£132m)

Figure 2

Sensitivity analysis showing impact on estimated total cost of changes in main variables, baseline total=£100.5m