Developing a health economic model for Asians with type 2 diabetes based on the Japan Diabetes Complications Study and the Japanese Elderly Diabetes Intervention Trial

Abstract

IntroductionCost-effectiveness analyses are becoming increasingly important in Japan following the introduction of a health technology assessment scheme. The study objective was to develop an economic model to evaluate the cost-effectiveness of two interventions for type 2 diabetes in a Japanese population.Research design and methodsThe Japan Diabetes Complications Study/Japanese Elderly Diabetes Intervention Trial risk engine (JJRE) Cost-Effectiveness Model (JJCEM) was developed, incorporating validated risk equations in Japanese patients with type 2 diabetes from the JJRE. Weibull regression models were developed for progression of the model outcomes, and a targeted literature review was performed to inform default values for utilities and costs. To illustrate outcomes, two simulated analyses were performed in younger (aged 40 years) and older (aged 80 years) Japanese populations, comparing a hypothetical treatment with placebo.ResultsThe model considers a population based on user-defined values for 11 baseline characteristic parameters and simulates rates of diabetic complications over a defined time horizon. Costs, quality-adjusted life years, and an incremental cost-effectiveness ratio are estimated. The model provides disaggregated results for two competing interventions, allowing visualization of the key drivers of cost and utility. A scatterplot of simulations and cost-effectiveness acceptability curve are generated for each analysis.ConclusionsThis is the first cost-effectiveness model for East Asian patients with type 2 diabetes, developed using Japan-specific risk equations. This population constitutes the largest share of the global population with diabetes, making this model highly relevant. The model can be used to evaluate the cost-effectiveness of anti-diabetic interventions in patients with type 2 diabetes in Japan and other East Asian populations.

The transferability and validity of a population-level simulation model for the economic evaluation of interventions in diabetes: the MICADO model

“…Finally, the MICADO model is a cohort level state-transition model while many diabetes simulation models consist of patient-level state transition models, or discrete event simulation models [ 19 , 24 , 31 , 32 ]. Our findings and adjustment steps may be more relevant to other cohort models [ 33 – 39 ], than to patient level models.…”

Prediction of complications in health economic models of type 2 diabetes: a review of methods used

“…IMIB[ 91 , 92 ], DiDACT[ 84 ], CDC[ 78 , 79 ], Grima[ 89 ], IHE[ 47 , 90 ], MICADO[ 95 , 96 ], and JJCEM[ 94 ]…”

“…Archimedes [72,73] Archimedes model BRAVO [74] Building, relating, assessing, and validating outcomes diabetes microsimulation model Cardiff [75] The Cardiff diabetes model Caro [76,77] NA: An economic evaluation model published by Caro et al CDC [78][79][80] NA: An economic evaluation model published by the CDC diabetes cost-effectiveness group CHIME [81] Chinese Hong Kong integrated modeling and evaluation COMT [82] Chinese outcomes model for type 2 diabetes Cornerstone [83] Cornerstone diabetes simulation model DiDACT [84] The diabetes decision analysis of cost-type 2 model DMM [85] The diabetes mellitus model EAGLE [86] Economic assessment of glycemic control and long-term effects of diabetes model Eastman [33,87] NA: An economic evaluation model published by Eastman et al ECHO [88] The economic and health outcomes model of type 2 diabetes mellitus GDM [16] The global diabetes model Grima [89] NA: An economic evaluation model published by Grima et al IHE [47,90] The Swedish institute for health economics diabetes cohort model IMIB [91,92] NA: An economic evaluation model published by Palmer (Institute for Medical Informatics and Biostatistics) et al IQVIA-CORE [93] The IQVIA center for outcomes research diabetes model JADE [5] The Januvia diabetes economic model JJCEM [94] The Japan diabetes complications study/Japanese elderly diabetes intervention trial risk engine cost-effectiveness model MICADO [95,96] Modelling integrated care for diabetes based on observational data Michigan [97] The Michigan model for diabetes ODEM [98] Ontario diabetes economic model PRIME [53] PRIME type 2 diabetes model PROSIT [99] The PROSIT disease modelling community (PROSIT in Latin means "it shall be useful") RAMP-DM…”

A Systematic Review of Methodologies Used in Models of the Treatment of Diabetes Mellitus

“…All three T1DM models identified in the systematic review are microsimulation models [34,36,50]. From the 26 T2DM models, 14 are cohort Markov models [31,33,39,41,45,[51][52][53][54][55][56][57][58][59], 11 are patient-level microsimulation models [30,32,35,37,38,40,[42][43][44][47][48][49], and 1 is a patient-level discrete-event models [46]. One model developed for T1DM and T2DM is a…”

“…The most frequently included retinopathy complication was blindness; for neuropathy complications the most frequently included was amputation; while end-stage renal disease (ESRD) and microalbuminuria were the most frequently included nephropathy complications. The models included various macrovascular complications and it is also worth noting that myocardial infarction (MI) was included in all the models apart from Deerochanawong et al 2021 [54] and Tanaka et al 2021 [55].…”