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Diabetes nephropathy in the Netherlands: a cost effectiveness analysis of national clinical guidelines
Background: In the Netherlands a program on quality assurance in medical care has started in 1996. Clinical professionals, patient organizations and health services researchers formulate evidence based guidelines with a concomitant cost-effectiveness analysis. Objectives: To examine the cost-effecti...
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| Published in: | Health policy (Amsterdam) 2000-04, Vol.51 (3), p.135-147 |
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| container_title | Health policy (Amsterdam) |
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| creator | van Os, Nicole Niessen, Louis W. Bilo, Henk J.G. Casparie, Anton F. van Hout, Ben A. |
| description | Background: In the Netherlands a program on quality assurance in medical care has started in 1996. Clinical professionals, patient organizations and health services researchers formulate evidence based guidelines with a concomitant cost-effectiveness analysis.
Objectives: To examine the cost-effectiveness of guideline recommendations for prevention of nephropathy in diabetes mellitus type 1 and 2.
Research design: A semi–Markov compartment model was developed. Data from international publications on epidemiological surveys and randomized trials, together with national data on health care use and costs, were used to feed the model. A cohort of diabetes patients without renal disease enters the model.
Measures: Complication (end-stage renal disease) free years, QALY's, and life-time medical costs per patient treated according to guideline recommendations or current anti-diabetic strategy.
Results: Guideline treatment for type 1 diabetes yields 4.2 complication free life years, at a cost-effectiveness ratio of 13 500 (Dutch guilders) NLG per QALY. Type 2 diabetes patients gain 0.2 complication free life years at a cost-effectiveness ratio of 31 000 NLG per QALY.
Conclusion: Guideline development for diabetes nephropathy, with concomitant cost-effectiveness calculations, has resulted in a transparent guideline with explicit information on long term cost and effects. The project has brought health care providers and health services researchers together. |
| doi_str_mv | 10.1016/S0168-8510(00)00063-4 |
| format | article |
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Objectives: To examine the cost-effectiveness of guideline recommendations for prevention of nephropathy in diabetes mellitus type 1 and 2.
Research design: A semi–Markov compartment model was developed. Data from international publications on epidemiological surveys and randomized trials, together with national data on health care use and costs, were used to feed the model. A cohort of diabetes patients without renal disease enters the model.
Measures: Complication (end-stage renal disease) free years, QALY's, and life-time medical costs per patient treated according to guideline recommendations or current anti-diabetic strategy.
Results: Guideline treatment for type 1 diabetes yields 4.2 complication free life years, at a cost-effectiveness ratio of 13 500 (Dutch guilders) NLG per QALY. Type 2 diabetes patients gain 0.2 complication free life years at a cost-effectiveness ratio of 31 000 NLG per QALY.
Conclusion: Guideline development for diabetes nephropathy, with concomitant cost-effectiveness calculations, has resulted in a transparent guideline with explicit information on long term cost and effects. The project has brought health care providers and health services researchers together.</description><identifier>ISSN: 0168-8510</identifier><identifier>EISSN: 1872-6054</identifier><identifier>DOI: 10.1016/S0168-8510(00)00063-4</identifier><identifier>PMID: 10720684</identifier><language>eng</language><publisher>Ireland: Elsevier Ireland Ltd</publisher><subject>Adolescent ; Child ; Child, Preschool ; Cohort Studies ; Consensus ; Cost of Illness ; Cost-Benefit Analysis ; Cost-effectiveness analysis ; Diabetes Mellitus, Type 1 - complications ; Diabetes Mellitus, Type 1 - economics ; Diabetes Mellitus, Type 1 - pathology ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - economics ; Diabetes Mellitus, Type 2 - pathology ; Diabetes nephropathy ; Diabetic Nephropathies - economics ; Diabetic Nephropathies - etiology ; Diabetic Nephropathies - prevention & control ; Disease Progression ; Guidelines ; Health administration ; Humans ; Infant ; Infant, Newborn ; Markov Chains ; Netherlands ; Practice Guidelines as Topic ; Preventive Health Services - economics ; Quality-Adjusted Life Years</subject><ispartof>Health policy (Amsterdam), 2000-04, Vol.51 (3), p.135-147</ispartof><rights>2000 Elsevier Science Ireland Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c428t-3b62ae00f50fbde0d95bb7b0491e9631fb330e747e2b268f907c070c7b69e0043</citedby><cites>FETCH-LOGICAL-c428t-3b62ae00f50fbde0d95bb7b0491e9631fb330e747e2b268f907c070c7b69e0043</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27922,27923</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10720684$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttp://econpapers.repec.org/article/eeehepoli/v_3a51_3ay_3a2000_3ai_3a3_3ap_3a135-147.htm$$DView record in RePEc$$Hfree_for_read</backlink></links><search><creatorcontrib>van Os, Nicole</creatorcontrib><creatorcontrib>Niessen, Louis W.</creatorcontrib><creatorcontrib>Bilo, Henk J.G.</creatorcontrib><creatorcontrib>Casparie, Anton F.</creatorcontrib><creatorcontrib>van Hout, Ben A.</creatorcontrib><title>Diabetes nephropathy in the Netherlands: a cost effectiveness analysis of national clinical guidelines</title><title>Health policy (Amsterdam)</title><addtitle>Health Policy</addtitle><description>Background: In the Netherlands a program on quality assurance in medical care has started in 1996. Clinical professionals, patient organizations and health services researchers formulate evidence based guidelines with a concomitant cost-effectiveness analysis.
Objectives: To examine the cost-effectiveness of guideline recommendations for prevention of nephropathy in diabetes mellitus type 1 and 2.
Research design: A semi–Markov compartment model was developed. Data from international publications on epidemiological surveys and randomized trials, together with national data on health care use and costs, were used to feed the model. A cohort of diabetes patients without renal disease enters the model.
Measures: Complication (end-stage renal disease) free years, QALY's, and life-time medical costs per patient treated according to guideline recommendations or current anti-diabetic strategy.
Results: Guideline treatment for type 1 diabetes yields 4.2 complication free life years, at a cost-effectiveness ratio of 13 500 (Dutch guilders) NLG per QALY. Type 2 diabetes patients gain 0.2 complication free life years at a cost-effectiveness ratio of 31 000 NLG per QALY.
Conclusion: Guideline development for diabetes nephropathy, with concomitant cost-effectiveness calculations, has resulted in a transparent guideline with explicit information on long term cost and effects. The project has brought health care providers and health services researchers together.</description><subject>Adolescent</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Cohort Studies</subject><subject>Consensus</subject><subject>Cost of Illness</subject><subject>Cost-Benefit Analysis</subject><subject>Cost-effectiveness analysis</subject><subject>Diabetes Mellitus, Type 1 - complications</subject><subject>Diabetes Mellitus, Type 1 - economics</subject><subject>Diabetes Mellitus, Type 1 - pathology</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - economics</subject><subject>Diabetes Mellitus, Type 2 - pathology</subject><subject>Diabetes nephropathy</subject><subject>Diabetic Nephropathies - economics</subject><subject>Diabetic Nephropathies - etiology</subject><subject>Diabetic Nephropathies - prevention & control</subject><subject>Disease Progression</subject><subject>Guidelines</subject><subject>Health administration</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Markov Chains</subject><subject>Netherlands</subject><subject>Practice Guidelines as Topic</subject><subject>Preventive Health Services - economics</subject><subject>Quality-Adjusted Life Years</subject><issn>0168-8510</issn><issn>1872-6054</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><recordid>eNqFUU2P1DAMjRCIHRZ-AignBIeC07RJywWh5VsrOADnKEkdGtRpS5IZaf49HrpacUPKs2PpPcd5ZuyxgBcChHr5jUJXda2AZwDPAUDJqrnDdqLTdaWgbe6y3S3lgj3I-ReRtJTqPrsQoGtQXbNj4W20DgtmPuM6pmW1ZTzxOPMyIv-CFNNk5yG_4pb7JReOIaAv8Ygz5sztbKdTjpkvgc-2xIVq7qc4R0-Xn4c4IBWYH7J7wU4ZH93kS_bj_bvvVx-r668fPl29ua58U3elkk7VFgFCC8ENCEPfOqcdNL3AXkkRnJSAutFYu1p1oQftQYPXTvUka-Qle7r1XdPy-4C5mH3MHif6Ay6HbLTQtVaqJWK7EX1ack4YzJri3qaTEWDOBpu_BpuzewbOhww25wc-b7qEK_pbESKOuC5TNEcjbSsonAg1yShFgiSsBCFbIxptxrKnZk9upj24PQ7_jLCthwivNwKSZ8eIyWQfcfY4xERbMMMS_zPvH0mIpKQ</recordid><startdate>20000401</startdate><enddate>20000401</enddate><creator>van Os, Nicole</creator><creator>Niessen, Louis W.</creator><creator>Bilo, Henk J.G.</creator><creator>Casparie, Anton F.</creator><creator>van Hout, Ben A.</creator><general>Elsevier Ireland Ltd</general><general>Elsevier</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>DKI</scope><scope>X2L</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20000401</creationdate><title>Diabetes nephropathy in the Netherlands: a cost effectiveness analysis of national clinical guidelines</title><author>van Os, Nicole ; Niessen, Louis W. ; Bilo, Henk J.G. ; Casparie, Anton F. ; van Hout, Ben A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c428t-3b62ae00f50fbde0d95bb7b0491e9631fb330e747e2b268f907c070c7b69e0043</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Adolescent</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Cohort Studies</topic><topic>Consensus</topic><topic>Cost of Illness</topic><topic>Cost-Benefit Analysis</topic><topic>Cost-effectiveness analysis</topic><topic>Diabetes Mellitus, Type 1 - complications</topic><topic>Diabetes Mellitus, Type 1 - economics</topic><topic>Diabetes Mellitus, Type 1 - pathology</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - economics</topic><topic>Diabetes Mellitus, Type 2 - pathology</topic><topic>Diabetes nephropathy</topic><topic>Diabetic Nephropathies - economics</topic><topic>Diabetic Nephropathies - etiology</topic><topic>Diabetic Nephropathies - prevention & control</topic><topic>Disease Progression</topic><topic>Guidelines</topic><topic>Health administration</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Markov Chains</topic><topic>Netherlands</topic><topic>Practice Guidelines as Topic</topic><topic>Preventive Health Services - economics</topic><topic>Quality-Adjusted Life Years</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>van Os, Nicole</creatorcontrib><creatorcontrib>Niessen, Louis W.</creatorcontrib><creatorcontrib>Bilo, Henk J.G.</creatorcontrib><creatorcontrib>Casparie, Anton F.</creatorcontrib><creatorcontrib>van Hout, Ben A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>RePEc IDEAS</collection><collection>RePEc</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Health policy (Amsterdam)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>van Os, Nicole</au><au>Niessen, Louis W.</au><au>Bilo, Henk J.G.</au><au>Casparie, Anton F.</au><au>van Hout, Ben A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diabetes nephropathy in the Netherlands: a cost effectiveness analysis of national clinical guidelines</atitle><jtitle>Health policy (Amsterdam)</jtitle><addtitle>Health Policy</addtitle><date>2000-04-01</date><risdate>2000</risdate><volume>51</volume><issue>3</issue><spage>135</spage><epage>147</epage><pages>135-147</pages><issn>0168-8510</issn><eissn>1872-6054</eissn><abstract>Background: In the Netherlands a program on quality assurance in medical care has started in 1996. Clinical professionals, patient organizations and health services researchers formulate evidence based guidelines with a concomitant cost-effectiveness analysis.
Objectives: To examine the cost-effectiveness of guideline recommendations for prevention of nephropathy in diabetes mellitus type 1 and 2.
Research design: A semi–Markov compartment model was developed. Data from international publications on epidemiological surveys and randomized trials, together with national data on health care use and costs, were used to feed the model. A cohort of diabetes patients without renal disease enters the model.
Measures: Complication (end-stage renal disease) free years, QALY's, and life-time medical costs per patient treated according to guideline recommendations or current anti-diabetic strategy.
Results: Guideline treatment for type 1 diabetes yields 4.2 complication free life years, at a cost-effectiveness ratio of 13 500 (Dutch guilders) NLG per QALY. Type 2 diabetes patients gain 0.2 complication free life years at a cost-effectiveness ratio of 31 000 NLG per QALY.
Conclusion: Guideline development for diabetes nephropathy, with concomitant cost-effectiveness calculations, has resulted in a transparent guideline with explicit information on long term cost and effects. The project has brought health care providers and health services researchers together.</abstract><cop>Ireland</cop><pub>Elsevier Ireland Ltd</pub><pmid>10720684</pmid><doi>10.1016/S0168-8510(00)00063-4</doi><tpages>13</tpages></addata></record> |
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| ispartof | Health policy (Amsterdam), 2000-04, Vol.51 (3), p.135-147 |
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| source | ScienceDirect Freedom Collection |
| subjects | Adolescent Child Child, Preschool Cohort Studies Consensus Cost of Illness Cost-Benefit Analysis Cost-effectiveness analysis Diabetes Mellitus, Type 1 - complications Diabetes Mellitus, Type 1 - economics Diabetes Mellitus, Type 1 - pathology Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - economics Diabetes Mellitus, Type 2 - pathology Diabetes nephropathy Diabetic Nephropathies - economics Diabetic Nephropathies - etiology Diabetic Nephropathies - prevention & control Disease Progression Guidelines Health administration Humans Infant Infant, Newborn Markov Chains Netherlands Practice Guidelines as Topic Preventive Health Services - economics Quality-Adjusted Life Years |
| title | Diabetes nephropathy in the Netherlands: a cost effectiveness analysis of national clinical guidelines |
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