Table 2.
Incremental Cost-Effectiveness of Individualized Versus Uniform Intensive Glycemic Control for Subpopulations of U.S. Adults With Diabetes Diagnosed at Age ≥30 Years
| Patient Characteristic | NHANES Population (95% CI), % | Incremental Lifetime Costs, $* | Incremental Life-Years | Incremental QALYs |
|---|---|---|---|---|
| Age | ||||
|
| ||||
| 30–44 y | 9 (6 to 13) | −16 365 | −0.10 | 0.20 |
|
| ||||
| 45–64 y | 48 (44 to 52) | −16 315 | −0.17 | 0.09 |
|
| ||||
| 65–75 y | 26 (21 to 31) | −11 692 | −0.10 | 0.04 |
|
| ||||
| >75 y | 17 (14 to 19) | −5401 | −0.09 | 0.05 |
| Complications† | ||||
|
| ||||
| No | 64 (58 to 70) | −14 885 | −0.14 | 0.10 |
|
| ||||
| Yes | 36 (30 to 42) | −10 452 | −0.11 | 0.04 |
| Comorbidity status‡ | ||||
|
| ||||
| Low | 58 (53 to 63) | −16 540 | −0.13 | 0.11 |
|
| ||||
| High | 42 (37 to 47) | −8863 | −0.13 | 0.04 |
| Diabetes duration | ||||
|
| ||||
| <10 y | 44 (38 to 50) | −14 508 | −0.14 | 0.10 |
|
| ||||
| ≥10 y | 56 (50 to 62) | −11 735 | −0.11 | 0.05 |
| Age 30–44 y | ||||
|
| ||||
| Without complications, with low comorbidity | 7 (3 to 11) | −18 191 | −0.08 | 0.25 |
|
| ||||
| With complications and low comorbidity | 2 (0 to 4) | −7901 | −0.11 | 0.02 |
|
| ||||
| Age 45–64 y, without complications, with low comorbidity | 35 (32 to 39) | −14 961 | −0.16 | 0.09 |
|
| ||||
| Age 65–75 y, without complications, with low comorbidity and diabetes for <10 y | 5 (3 to 7) | −10 131 | −0.10 | 0.08 |
|
| ||||
| All other patients§ | 50 (48 to 53) | −11 982 | −0.12 | 0.05 |
NHANES = National Health and Nutrition Examination Survey; QALY = quality-adjusted life-year.
Expressed in 2015 U.S. dollars. Negative values indicate cost savings from individualized vs. uniform intensive control.
Self-reported history of angina pectoris, myocardial infarction, stroke, coronary heart disease, congestive heart failure, or retinopathy; receipt of dialysis in previous year; or measured albumin–creatinine ratio >300 mg/g.
Calculated by using a weighted combined Charlson Comorbidity Index score based on the patient’s self-report of myocardial infarction, heart failure, stroke, lung disease, rheumatoid arthritis, liver disease, diabetes, and cancer (excluding skin cancer). A score <5 (vs. ≥5) indicated low (vs. high) comorbidity status.
Those aged 30–44 y with complications and high comorbidity, those aged 45–75 y with complications, all patients aged >75 y, and all patients with high comorbidity.