The cost-effectiveness analysis of JinQi Jiangtang tablets for the treatment on prediabetes: a randomized, double-blind, placebo-controlled, multicenter design

摘要

Background At present, diabetes is a chronic disease of great cost and heavy burdens. The International Diabetes Federation has repeatedly warned that by 2025, the global number of diabetics would rise to 333 million from 194 million in 2003. Although the occurrence of diabetes in developing countries is lower, China has a large population, so that the number of cases is increased. At the same time, more people have prediabetes, a growing health concern where a large percentage of the patients develop full type 2 diabetes. In addition, the patients of diabetes easily incur complications such as blindness, kidney failure, and cardiovascular diseases that can seriously affect the patients’ quality of life and cause great economic burdens to family and society. Therefore, effective interventions for prediabetes are needed to prevent or delay the occurrence and development of diabetes. Methods A randomized controlled trial that was assessed with pharmacoeconomic methods was undertaken in this study. The study term was 24?months (12?months for the intervention and 12?months for follow up). Four hundred participants, recruited from four cities in China: Beijing, Tianjin, Xian, and Naning, were randomized to the treatment group (JQJT tablets) and the control group (placebo). Participants included in this study had been diagnosed with prediabetes according to the criteria for western medicine and Traditional Chinese Medicine (TCM). The end-point effectiveness indexes included the incidence of diabetes and the reversion rate. The drug costs and lifestyle intervention costs were included in the total costs. The study used the cost-effectiveness analysis to discuss the economic advantage of the JQJT tablets. Results The?outcomes?of?the?study?contained?2?sections,namely?clinical?outcomes?and cost-effectiveness?analysis?outcomes. The?clinical?outcomes: the?treatment?group?and?control?group?had?no?significant?statistical?difference P> 0.05)?on?the?baseline?of?situation;?Jinqi?Jiangtang?tablet?effectively?reduced?the?incidence?of?diabetes mellitus?and enhanced reversion?rate.?compared?with?the?control?group (p 0.05); finally?the?compliance?of?participants?between?the?two?groups?had?no?signicant?difference. The?cost-effectiveness analysis outcomes:in?the?intervention?period?of?12?months,on?the?aspect?of?reversion?rate,?the?treatment?group had?better economic?advantage?by?using?cost-effectiveness?ratio?and?the?incremental?cost-effectiveness?ratio;on?the?aspect of the incidence?of?diabetes,?the?control?group?had?better?economic?advantage?by?using?cost-effectiveness?ratio?and?the incremental cost-effectiveness?ratio; in?the?follow-up?peiod?of?24?months, on?the?aspect?of?reversion?rate,?the?treatment group had?better?economic?advantage?by?using?cost-effectiveness?ratio?and?the?incremental?cost-effectiveness?ratio,?on the aspect?of?the?incidence?of?diabetes,?the?control?group?had?better?economic?advantage?by?using?cost-effectivenes ratio and?the?incremental?cost-effectiveness?ratio.At?the?same?time, these?outcomes?remained?the?same?by?sensitivity?analysis. Assuming?that?prices?and?resident?incomes?rose?5%, the?sensitiveness?analysis?shows?that?the?two?group?affected?by the paremeters?changed?little. Conclusion The importance and effectiveness of lifestyle education and JinQi Jiangtang tablets was proven. In both the intervention period and follow-up, JinQi Jiangtang tablets combined with lifestyle education had a greater cost advantage effect than the lifestyle education alone on the reversion rate; the lifestyle education had a greater cost advantage effect than the JinQi Jiangtang tablets combined with lifestyle education on the incidence of diabetes. Trial registration Chinese Clinical Trials ChiCTR-TRC-09000401 ) , registered on 25 May 2009.