Economic outcomes of treatment strategies for type 2 diabetes mellitus and coronary artery disease in the Bypass Angioplasty Revascularization Investigation 2 Diabetes trial

The economic outcomes of clinical management strategies are important in assessing their value to patients. Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) randomized patients with type 2 diabetes mellitus and angiographically documented, stable coronary disease to strategies...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 2009-12, Vol.120 (25), p.2550-2558
Main Authors: Hlatky, Mark A, Boothroyd, Derek B, Melsop, Kathryn A, Kennedy, Laurence, Rihal, Charanjit, Rogers, William J, Venkitachalam, Lakshmi, Brooks, Maria M
Format: Article
Language:English
Subjects:
Angioplasty, Balloon, Coronary - economics
Coronary Artery Bypass - economics
Coronary Artery Disease - economics
Coronary Artery Disease - etiology
Coronary Artery Disease - therapy
Cost-Benefit Analysis
Diabetes Mellitus, Type 2 - complications
Diabetes Mellitus, Type 2 - drug therapy
Diabetes Mellitus, Type 2 - economics
Female
Health Care Costs - statistics & numerical data
Humans
Insulin - therapeutic use
Longitudinal Studies
Male
Middle Aged
Randomized Controlled Trials as Topic
Treatment Outcome
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Summary:The economic outcomes of clinical management strategies are important in assessing their value to patients. Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) randomized patients with type 2 diabetes mellitus and angiographically documented, stable coronary disease to strategies of (1) prompt revascularization versus medical therapy with delayed revascularization as needed to relieve symptoms and (2) insulin sensitization versus insulin provision. Before randomization, the physician declared whether coronary artery bypass grafting or percutaneous coronary intervention would be used if the patient were assigned to revascularization. We followed 2005 patients for medical utilization and costs and assessed the cost-effectiveness of these management strategies. Medical costs were higher for revascularization than medical therapy, with a significant interaction with the intended method of revascularization (P
ISSN:0009-7322
1524-4539
DOI:10.1161/CIRCULATIONAHA.109.912709