The CEA Registry Blog

By CEA Registry Team on 11/29/2011 4:50 PM

November is American Diabetes Month.  Between 18[1] and 26[2] million individuals in the US live with diabetes, resulting in an estimated economic burden of nearly 220[1] billion in 2007.  Recent research by the International Diabetes Federation suggests the disease will become more prevalent, with 1 in 10 adults suffering from diabetes by 2030[3].  

To recognize American Diabetes Month, the CEA Registry Blog is highlighting research on the cost-effectiveness of diabetes-related interventions.  Using the ‘advanced search’ feature of the CEA Registry, we searched for cost-effectiveness ratios examining endocrine disorders among US populations published since 2009.  We restricted results to treatments indicated for Type-II diabetes.  

The data* suggest that many diabetes-related interventions are cost-effective by traditional standards, with estimates ranging from dominant (Pioglitazone plus metformin vs. rosiglitazone plus metformin) (St Charles, 2009)[4]to $100,000 per QALY gained (aggressive treatment of hypertension, hyperlipidemia, and hyperglycemia vs. usual treatment)(Tasosa, 2010)[5].  Notably, only one study included here evaluated a surgical intervention (bariatric surgery for severely obese adults with diabetes) (Hoerger, 2010)[6].  With a ratio of $12,000 per QALY gained this therapeutic approach was estimated to be more cost-effective than many pharmaceutical interventions evaluated over the same time period. 

By: Michael J. Cangelosi

*Note: Click on "Read More" link below to examine all the data.

[1] Dall TM et al.  The Economic Burden of Diabetes.  Health Affairs 2010(2):297-303.
[2] American Diabetes Association.  American Diabetes Month. Accessed on: 2011 11 17. Available at: 
[3] Ben Hirschler reporting for Reuters.  Diabetes forecast to hit one in 10 adults by 2030.  Accessed on 2011 11 17.  Available at: 
[4] St Charles M et al. A cost-effectivenss analysis of pioglitazone plus metformin compared with rosiglitazone plus metformin from a thir-party payre perspective in the U.S.  Curr Med Res Opin 2009 Jun;25(6):1343-53.
[5] Tasosa J, Schuster R, and McAlearney JS.  Cost-effectiveness of treating hypertension, hyperglycemia, and hyperlipidemia in African Americans and the general population with type-2 diabetes.  J Health Care Poor Underserved 2010 Feb; 21(1):161-76.
[6] Hoerger TJ et al. Cost effectiveness of bariatric surgery for severely obese adults with diabetes.  Diabetes Care. 2010 Sep; 33(9):1933-9.
By CEA Registry Team on 11/22/2011 3:20 PM

The CEA Registry is now updated with the first of three rounds of published cost-effectiveness articles from 2011.  Data from 80 new articles were added to the Registry. 

The Registry now contains the following:

•    2,815 cost-utility analyses on a wide variety of diseases and treatments
•    7,300 cost-effectiveness ratios
•    More than 10,300 utility weights

By CEA Registry Team on 11/16/2011 11:10 AM

Twice each month we highlight recently published cost-utility studies and selected reviews and editorials.

1. Carlos F, Ramos E, Ram Rez-G Mez J, et al. Economic evaluation of duloxetine as first-line treatment for painful diabetic peripheral neuropathy in Mexico. J Med Econ. 2011 Nov 15. [Epub ahead of print] PubMed PMID: 22082033.

2. Nichol MB, Wu J, Huang J, et al. Cost-effectiveness of Prostate Health Index for prostate cancer detection. BJU Int. 2011 Nov 11. [Epub ahead of print] PubMed PMID: 22077934.

3. Gurusamy K, Wilson E, Burroughs AK, et al. Intra-Operative vs Pre-Operative Endoscopic Sphincterotomy in Patients with Gallbladder and Common Bile Duct Stones: Cost-Utility and Value-of-Information Analysis. Appl Health Econ Health Policy. 2011 Nov 11. [Epub ahead of print] PubMed PMID: 22077427.

4. Watt M, Mealing S, Eaton J, et al. Cost-effectiveness of transcatheter aortic valve replacement in patients ineligible for conventional aortic valve replacement. Heart. 2011 Nov 10. [Epub ahead of print] PubMed PMID: 22076021.

5. Davis S, Westby M, Pitcher D, et al. Implantable loop recorders are cost-effective when used to investigate transient loss of consciousness which is either suspected to be arrhythmic or remains unexplained. Europace. 2011 Nov 8. [Epub ahead of print] PubMed PMID: 22071383.

6. Neelemaat F, Bosmans JE, Thijs A, et al. Oral nutritional support in malnourished elderly decreases functional limitations with no extra costs Cost-effectiveness & functional limitations. Clin Nutr. 2011 Nov 8. [Epub ahead of print] PubMed PMID: 22071290.

7. Shaw AD, Chalfin DB, Kleintjens J. The economic impact and cost-effectiveness of urinary neutrophil gelatinase-associated lipocalin after cardiac surgery. Clin Ther. 2011 Nov 7. [Epub ahead of print] PubMed PMID: 22071237.

8. Hultman B, Lundkvist J, Glimelius B, et al. Costs and clinical outcome of neoadjuvant systemic chemotherapy followed by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in peritoneal carcinomatosis from gastric cancer. Acta Oncol. 2011 Nov 10. [Epub ahead of print] PubMed PMID: 22070666.

9. Grzeszczak W, Czupryniak L, Kolasa K, et al. The Cost-Effectiveness of Saxagliptin Versus NPH Insulin When Used in Combination with Other Oral Antidiabetes Agents in the Treatment of Type 2 Diabetes Mellitus in Poland. Diabetes Technol Ther. 2011 Nov 8. [Epub ahead of print] PubMed PMID: 22066527.

10. Lin MM, Goldsmith JD, Resch SC, et al. Histologic Examinations of Arthroplasty Specimens are not Cost-effective: A Retrospective Cohort Study. Clin Orthop Relat Res. 2011 Nov 5. [Epub ahead of print] PubMed PMID: 22057818.

11. Rein DB, Smith BD, Wittenborn JS, et al. The Cost-Effectiveness of Birth-Cohort Screening for Hepatitis C Antibody in U.S. Primary Care Settings. Ann Intern Med. 2011 Nov 4.[Epub ahead of print] PubMed PMID: 22056542.

12. Adogwa O, Parker SL, et al. Cost per quality-adjusted life year gained of revision neural decompression and instrumented fusion for same-level recurrent lumbar stenosis: defining the value of surgical intervention. J Neurosurg Spine. 2011 Nov 4. [Epub ahead of print] PubMed PMID: 22054639.

13. Adogwa O, Parker SL, Shau DN, et al. Cost per quality-adjusted life year gained of laminectomy and extension of instrumented fusion for adjacent-segment disease: defining the value of surgical intervention. J Neurosurg Spine. 2011 Nov 4. [Epub ahead of print] PubMed PMID: 22054637.

14. Rogers JG, Bostic RR, Tong KB, et al. Cost-Effectiveness Analysis of Continuous Flow Left Ventricular Assist Devices as Destination Therapy. Circ Heart Fail. 2011 Nov 3. [Epub ahead of print] PubMed PMID: 22052901.

15. Retel VP, van der Molen L, Hilgers FJ, et al. A cost-effectiveness analysis of a preventive exercise program for patients with advanced head and neck cancer treated with concomitant chemo-radiotherapy. BMC Cancer. 2011 Nov 3;11(1):475. [Epub ahead of print]PubMed PMID: 22051143.

16. Ohsfeldt RL, Olsson AG, Jensen MM, et al. Cost-effectiveness of rosuvastatin 20 mg for the prevention of cardiovascular morbidity and mortality: a Swedish economic evaluation of the JUPITER trial. J Med Econ. 2011 Nov 4. [Epub ahead of print] PubMed PMID: 22050473.

17. Tosteson AN, Tosteson TD, Lurie JD, et al. Comparative effectiveness evidence from the spine patient outcomes research trial: surgical versus nonoperative care for spinal stenosis, degenerative spondylolisthesis, and intervertebral disc herniation. Spine (Phila Pa 1976). 2011 Nov 15;36(24):2061-8. PubMed PMID: 22048651.

18. Landman MP, Feurer ID, Pinson CW, et al. Which is more cost-effective under the MELD system: primary liver transplantation, or salvage transplantation after hepatic resection or after loco-regional therapy for hepatocellular carcinoma within Milan criteria? HPB (Oxford). 2011 Nov;13(11):783-91. Epub 2011 Aug 19. PubMed PMID: 21999591.

19. Conly J, Clement F, Tonelli M, et al. Cost-effectiveness of the use of low- and high-potency statins in people at low cardiovascular risk. CMAJ. 2011 Nov 8;183(16):E1180-E1188. Epub 2011 Oct 11. PubMed PMID: 21989469.

20. Gidwani R, Khan ZM, Fenaux P, et al. A cost-effectiveness analysis of using azacitidine vs. decitabine in treating patients with myelodysplastic syndromes. J Med Econ. 2011 Nov 4. [Epub ahead of print] PubMed PMID: 21988635.

21. Chen NC, Shauver MJ, Chung KC. Cost-effectiveness of open partial fasciectomy, needle aponeurotomy, and collagenase injection for dupuytren contracture. J Hand Surg Am. 2011 Nov;36(11):1826-1834.e32. Epub 2011 Oct 5. PubMed PMID: 21981831.

22. Klarenbach S, Cameron C, Singh S, et al. Cost-effectiveness of second-line antihyperglycemic therapy in patients with type 2 diabetes mellitus inadequately controlled on metformin. CMAJ. 2011 Nov 8;183(16):E1213-20. Epub 2011 Oct 3. PubMed PMID: 21969406.

23. Pham B, Stern A, Chen W, et al. Preventing Pressure Ulcers in Long-term Care: A Cost-effectiveness Analysis. Arch Intern Med. 2011 Nov 14;171(20):1839-47. Epub 2011 Sep 26. PubMed PMID: 21949031.

24. Bogaards JA, Coupé VM, Meijer CJ, et al. The clinical benefit and cost-effectiveness of human papillomavirus vaccination for adult women in the Netherlands. Vaccine. 2011 Nov 8;29(48):8929-36. Epub 2011 Sep 22. PubMed PMID: 21945961.

25. Robberstad B, Frostad CR, Akselsen PE, et al. Economic evaluation of second generation pneumococcal conjugate vaccines in Norway. Vaccine. 2011 Nov 3;29(47):8564-74. Epub 2011 Sep 21. PubMed PMID: 21945264.

26. Tunis SL. Cost Effectiveness of Self-Monitoring of Blood Glucose (SMBG) for Patients with Type 2 Diabetes and Not on Insulin: Impact of Modelling Assumptions on Recent Canadian Findings. Appl Health Econ Health Policy. 2011 Nov 1;9(6):351-65. PubMed PMID: 21892840.

27. McMahon PM, Kong CY, Bouzan C, et al. Cost-Effectiveness of Computed Tomography Screening for Lung Cancer in the United States. J Thorac Oncol. 2011 Nov;6(11):1841-1848. PubMed PMID: 21892105.

28. Li H, Robinson KA, Anton B, et al. Cost-effectiveness of a novel molecular test for cytologically indeterminate thyroid nodules. J Clin Endocrinol Metab. 2011 Nov;96(11):E1719-26. Epub 2011 Aug 24. PubMed PMID: 21865367.

29. Scotland G, Waugh N, Royle P, et al. Denosumab for the prevention of osteoporotic fractures in post-menopausal women: a NICE single technology appraisal. Pharmacoeconomics. 2011 Nov 1;29(11):951-61. PubMed PMID: 21854080.

30. Maniadakis N, Ekman M, Calvert MJ, et al. Cost effectiveness of cardiac resynchronization therapy in Greece: an analysis based on the CArdiac REsychronization in Heart Failure trial. Europace. 2011 Nov;13(11):1597-603. Epub 2011 Aug 6. PubMed PMID: 21821852.

31. Chan K, Davis J, Pai SY, et al. A Markov model to analyze cost-effectiveness of screening for severe combined immunodeficiency (SCID). Mol Genet Metab. 2011 Nov;104(3):383-9. Epub 2011 Jul 12. PubMed PMID: 21810544.

32. Ananthakrishnan AN, Hur C, Juillerat P, et al. Strategies for the prevention of postoperative recurrence in Crohn's disease: results of a decision analysis. Am J Gastroenterol. 2011 Nov;106(11):2009-17. Epub 2011 Jul 26. PubMed PMID: 21788991.

33. Aberg F, Mäklin S, Räsänen P, et al. Cost of a quality-adjusted life year in liver transplantation: The influence of the indication and the model for end-stage liver disease score. Liver Transpl. 2011 Nov;17(11):1333-43. PubMed PMID: 21770017.

34. Jouquet G, Bygrave H, Kranzer K, et al. Cost and Cost-Effectiveness of Switching From d4T or AZT to a TDF-Based First-Line Regimen in a Resource-Limited Setting in Rural Lesotho. J Acquir Immune Defic Syndr. 2011 Nov 1;58(3):e68-74. PubMed PMID: 21765366.

35. Price D, Gray A, Gale R, et al. Cost-utility analysis of indacaterol in Germany: a once-daily maintenance bronchodilator for patients with COPD. Respir Med. 2011 Nov;105(11):1635-47. Epub 2011 Jul 20. PubMed PMID: 21764277.

36. Campbell HE, Epstein D, Bloomfield D, et al. The cost-effectiveness of adjuvant chemotherapy for early breast cancer: A comparison of no chemotherapy and first, second, and third generation regimens for patients with differing prognoses. Eur J Cancer. 2011 Nov;47(17):2517-30. Epub 2011 Jul 7. PubMed PMID: 21741831.

37. Spronk S, van Kempen BJ, Boll AP, et al. Cost-effectiveness of screening for abdominal aortic aneurysm in the Netherlands and Norway. Br J Surg. 2011 Nov;98(11):1546-55. Epub 2011 Jul 4. PubMed PMID: 21725968.

38. Park KT, Perez F, Tsai R, et al. Cost-effectiveness Analysis of Adjunct VSL#3 Therapy Versus Standard Medical Therapy in Pediatric Ulcerative Colitis. J Pediatr Gastroenterol Nutr. 2011 Nov;53(5):489-96. PubMed PMID: 21694634.

39. Gelsomino S, Lorusso R, Livi U, et al. Cost and cost-effectiveness of cardiac surgery in elderly patients. J Thorac Cardiovasc Surg. 2011 Nov;142(5):1062-73. Epub 2011 Apr 13. PubMed PMID: 21492881.

40. Benucci M, Saviola G, Baiardi P, et al. Cost-effectiveness treatment with Rituximab in patients with rheumatoid arthritis in real life. Rheumatol Int. 2011 Nov;31(11):1465-9. Epub 2010 May 16. PubMed PMID: 20473760.

By Teja Thorat

By CEA Registry Team on 11/1/2011 9:36 AM

Twice each month we highlight recently published cost-utility studies and selected reviews and editorials.

1. Díez-Domingo J, Ridao-López M, Gutiérrez-Gimeno MV, et al. Pharmacoeconomic assessment of implementing a universal PCV-13 vaccination programme in the Valencian public health system (Spain). Vaccine. 2011 Oct 22. [Epub ahead of print] PubMed PMID: 22027484.

2. Mullins CD, Hsiao FY, Onukwugha E, et al. Comparative and cost-effectiveness of oxaliplatin-based or irinotecan-based regimens compared with 5-fluorouracil/leucovorin alone among US elderly stage IV colon cancer patients. Cancer. 2011 Oct 21. [Epub ahead of print] PubMed PMID: 22020739.

3. Cunio Machado Fonseca M, Tannus Branco de Araújo G, Etto H, et al. Economic Evaluation of Clodronate and Zoledronate in Patients Diagnosed With Metastatic Bone Disease From the Perspective of Public and Third Party Payors in Brazil. Clin Ther. 2011 Oct 22. [Epub ahead of print] PubMed PMID: 22019346.

4. Valentine WJ, Palmer AJ, Lammert M, et al. Evaluating the Long-Term Cost-Effectiveness of Liraglutide Versus Exenatide BID in Patients With Type 2 Diabetes Who Fail to Improve With Oral Antidiabetic Agents. Clin Ther. 2011 Oct 19. [Epub ahead of print] PubMed PMID: 22018679.

5. Lock K, Wilson K, Murphy D, et al. A cost-effectiveness model of smoking cessation based on a randomised controlled trial of varenicline versus placebo in patients with chronic obstructive pulmonary disease. Expert Opin Pharmacother. 2011 Oct 21. [Epub ahead of print] PubMed PMID: 22017336.

6. Gordon J, Lister S, Prettyjohns M, et al. A cost-utility study of the use of pregabalin in treatment-refractory neuropathic pain. J Med Econ. 2011 Oct 21. [Epub ahead of print] PubMed PMID: 22017236.

7. Berendsen BA, Hendriks MR, Verhagen EA, et al. Effectiveness and cost-effectiveness of 'BeweegKuur', a combined lifestyle intervention in the Netherlands: rationale, design and methods of a randomized controlled trial. BMC Public Health. 2011 Oct 19;11(1):815. [Epub ahead of print] PubMed PMID: 22011308.

8. Te Ao BJ, Brown PM, Feigin VL, et al. Are stroke units cost effective? Evidence from a New Zealand stroke incidence and population-based study. Int J Stroke. 2011 Oct 20. doi: 10.1111/j.1747-4949.2011.00632.x. [Epub ahead of print]PubMed PMID: 22010968.

9. Hill JC, Whitehurst DG, Lewis M, et al. Comparison of stratified primary care management for low back pain with current best practice (STarT Back): a randomised controlled trial. Lancet. 2011 Oct 29;378(9802):1560-71. Epub 2011 Sep 28. PubMed PMID: 21963002.

10. Shiroiwa T, Fukuda T, Shimozuma K. Cost-effectiveness analysis of trastuzumab to treat HER2-positive advanced gastric cancer based on the randomised ToGA trial. Br J Cancer. 2011 Oct 25;105(9):1273-8. Epub 2011 Sep 29. PubMed PMID: 21959871.

11. Nelson RE, Saltzman GM, Skalabrin EJ, et al. The cost-effectiveness of telestroke in the treatment of acute ischemic stroke. Neurology. 2011 Oct 25;77(17):1590-8. Epub 2011 Sep 14. PubMed PMID: 21917781.

12. Newall AT, Creighton P, Philp DJ, et al. The potential cost-effectiveness of infant pneumococcal vaccines in Australia. Vaccine. 2011 Oct 19;29(45):8077-85. Epub 2011 Aug 22. PubMed PMID: 21864617.

13. Chesson HW, Ekwueme DU, Saraiya M, et al. The cost-effectiveness of male HPV vaccination in the United States. Vaccine. 2011 Oct 26;29(46):8443-50. Epub 2011 Aug 2. PubMed PMID: 21816193.

By Teja Thorat

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