Orlistat in responding obese type 2 diabetic patients: meta-analysis findings and cost-effectiveness as rationales for reimbursement in Sweden and Switzerland
| العنوان: | Orlistat in responding obese type 2 diabetic patients: meta-analysis findings and cost-effectiveness as rationales for reimbursement in Sweden and Switzerland |
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| المؤلفون: | Ruof, J, Golay, A, Berne, Christian, Collin, C, Lentz, J, Maetzel, A |
| المصدر: | International Journal of Obesity. 29(5):517-523 |
| مصطلحات موضوعية: | Anti-Obesity Agents/economics/*therapeutic use, Blood Pressure/drug effects, Cost-Benefit Analysis/methods, Diabetes Mellitus, Type 2/*drug therapy/economics, Hemoglobin A, Glycosylated/analysis, Humans, Insurance, Health, Reimbursement/economics, Lactones/economics/*therapeutic use, Obesity/*drug therapy, Sweden, Switzerland, Treatment Outcome, Weight Loss/drug effects |
| الوصف: | OBJECTIVE: The aim of this study is to review the clinical and economic rationale for the reimbursement of orlistat in responding obese patients with type 2 diabetes.METHODS: Data from seven randomized controlled clinical trials of orlistat in overweight and obese patients with type 2 diabetes were pooled. A subgroup analysis involving patients who achieved a response (defined as a weight loss of >/=5% after 12 weeks of treatment) was conducted. The outcomes of the pooled analysis were then used to construct a Markov health economic model covering an 11-y period. The incidences of diabetes-related micro- and macrovascular complications were derived from the United Kingdom Prospective Diabetes Study. The effects of changes in body mass index, and the impact of micro- and macrovascular complications on utilities were derived from published sources. Publicly available cost data were used and are presented here in 2001 Euros. Discounting of 3% was applied. A probabilistic sensitivity analysis was conducted to examine the robustness of results.RESULTS: A total of 1249 patients treated with orlistat and 1230 given placebo were eligible for the intent-to-treat analysis. At the end of the study period, 23% of orlistat patients achieved a weight reduction of >/=5%. These patients showed a mean decrease in HbA1C of 1.16%, a weight reduction of 8.6 kg, a reduction in total cholesterol of 5.3% and a reduction in systolic blood pressure of 5.2 mmHg. The base-case economic analysis revealed costs per quality-adjusted life year gained of euro14 000 in Sweden and euro13 600 in Switzerland.CONCLUSION: The data presented here support the utilization and reimbursement of orlistat in overweight and obese diabetic patients who respond to the treatment. |
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| الوصول الحر: | https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-80020Test http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Retrieve&list_uids=15738932&dopt=CitationTest |
| قاعدة البيانات: | SwePub |
| تدمد: | 03070565 14765497 |
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| DOI: | 10.1038/sj.ijo.0802925 |