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Farmer AJ, Stevens R, Hirst J, et al. Optimal strategies for identifying kidney disease in diabetes: properties of screening tests, progression of renal dysfunction and impact of treatment – systematic review and modelling of progression and cost-effectiveness. Southampton (UK): NIHR Journals Library; 2014 Feb. (Health Technology Assessment, No. 18.14.)

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Optimal strategies for identifying kidney disease in diabetes: properties of screening tests, progression of renal dysfunction and impact of treatment – systematic review and modelling of progression and cost-effectiveness.

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Appendix 5Summary of current diabetes health economic models

Do current models allow the impact of treatment based on renal status to be evaluated?

The following table lists is a detailed list of health economic models for diabetes including a brief comment about the extent to which the models include parameters relating to the presence of and severity of nephropathy in modelling costs or outcomes.

ModelReferenceExtent to which nephropathy addressedType of diabetes
Type 1 diabetes models
DCCT 1996Diabetes Control and Complications Trial Research Group. Lifetime benefits and costs of intensive therapy as practiced in the Diabetes Control and Complications Trial. The Diabetes Control and Complications Trial Research Group. JAMA 1996;276:1409–15Includes Markov submodel for nephropathyType 1
Palmer et al. 2000Palmer AJ, Weiss C, Sendi PP, Neeser K, Brandt A, Singh G, et al. The cost-effectiveness of different management strategies for type I diabetes: a Swiss perspective. Diabetologia 2000;43:13–26Includes modelling as a progression through disease states to ESRD mortalityType 1
Type 2 diabetes models
Eastman et al. 1997Eastman RC, Javitt JC, Herman WH, Dasbach EJ, Zbrozek AS, Dong F, et al. Model of complications of NIDDM: I. model construction and assumptions. Diabetes Care 1997;20:725–34. URL: http://care​.diabetesjournals​.org/content/20/5/725.shortIncludes four submodels for nephropathyType 2
Global diabetes modelBrown JB, Russell A, Chan W, Pedula K, Aickin M. The global diabetes model: user friendly version 3.0. Diabetes Res Clin Pract 2000;50:S15–46Makes use of the Eastman et al. 1997 modelType 2
Cardiff diabetes model156No publication found – reported in: http://care​.diabetesjournals​.org/content/30/6/1638.full.pdfIncludes data on renal events from DCCT45 and UKPDS 6422Type 2
Sheffield diabetes model156No publication found – reported in: http://care​.diabetesjournals​.org/content/30/6/1638.full.pdfIncludes a submodel for nephropathy. Nephropathy model based on Eastman et al. 1997 model of diabetes progression and the DCCT research group228Type 2
UKPDS outcomes modelClarke PM, Gray AM, Briggs A, Farmer A, Fenn P, Stevens R, et al. A model to estimate the lifetime health outcomes of patients with type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS) outcomes model. Diabetologia 2004;47:1747–59. URL: www​.springerlink.com​/content/29qrwyvccp0yjeje/fulltext.pdfModel contains a single Weibull equation to predict renal failureType 2
UKPDS risk engineStevens RJ, Kothari V, Adler AI, Stratton IM, Holman RR. The UKPDS risk engine: a model for the risk of coronary heart disease in type II diabetes (UKPDS 56). Clin Science 2001;101:671–9. URL: http://www​.clinsci.org​/cs/101/0671/1010671.pdfNo renal componentType 2
CDC/RTI type 2 diabetes progression modelHoerger TJ, Harris R, Hicks KA, Donahue K, Sorensen S, Engelgau M. Screening for type 2 diabetes mellitus: a cost-effectiveness analysis. Ann Intern Med 2004;140:689–99. URL: www​.annals.org/content/140/9/689​.full.pdfIncludes simulation for nephropathy and ESRDType 2
Caro et al. 2000Caro JJ, Klittich WS, Raggio G, Kavanagh PL, O’Brien JA, Shomphe LA, et al. Economic assessment of troglitazone as an adjunct to sulfonylurea therapy in the treatment of type 2 diabetes. Clin Ther 2000;22:116–27Includes five states of nephropathyType 2
Palmer et al. 2000Palmer A, Sendi P, Spinas G. Applying some UK Prospective Diabetes Study results to Switzerland: the cost-effectiveness of intensive glycaemic control with metformin versus conventional control in overweight patients with type-2 diabetes. Schweiz Med Wochenschr 2000;130:1034Includes renal failure and death from renal diseaseType 2
Bagust et al. 2001Bagust A, Hopkinson P, Maier W, Currie C. An economic model of the long-term health care burden of type II diabetes. Diabetologia 2001;44:2140–55Includes three independent modules governing nephropathyType 2
US Centre for Disease Control 2002Hoerger T, Bethke A, Richter A, Sorensen S, Engelgau M, Thompson T, et al. Cost-effectiveness of intensive glycemic control, intensified hypertension control, and serum cholesterol level reduction for type 2 diabetes. JAMA 2002;287:2542–51Renal outcomes modelled as progression through to death by ESRDType 2
Zhou et al. 2005Zhou H, Isaman DJ, Messinger S, Brown MB, Klein R, Brandle M, et al. A computer simulation model of diabetes progression, quality of life, and cost. Diabetes Care 2005;28:2856–63Includes separate Markov submodel corresponding to three states of nephropathyType 2
Tilden et al. 2007Tilden DP, Mariz S, O’Bryan-Tear G, Bottomley J, Diamantopoulos A. A lifetime modelled economic evaluation comparing pioglitazone and rosiglitazone for the treatment of type 2 diabetes mellitus in the UK. Pharmacoeconomics 2007;25:39–54Includes renal failureType 2
Types 1 and 2 diabetes models
IMIB modelPalmer AJ, Brandt A, Gozzoli V, Weiss C, Stock H, Wenzel H. Outline of a diabetes disease management model: principles and applications. Diabetes Res Clin Pract 2000;50:S47–56. URL: www​.sciencedirect.com​/science/article/pii/S0168822700002163Includes renal submodel of eight statesType 1 and type 2
EAGLE modelMueller E, Maxion-Bergemann S, Gultyaev D, Walzer S, Freemantle N, Mathieu C, et al. Development and validation of the economic assessment of glycemic control and long-term effects of diabetes (EAGLE) model. Diabetes Technol Ther 2006;8:219–36. URL: www​.liebertonline.com/doi/pdfplus/10​.1089/dia.2006.8.219Can simulate kidney system (microalbuminuria, macroalbuminuria, ESRD)Type 1 and type 2
Core diabetes modelPalmer AJ, Roze S, Valentine WJ, Minshall ME, Foos V, Lurati FM, et al. The CORE diabetes model: projecting long-term clinical outcomes, costs and cost-effectiveness of interventions in diabetes mellitus (types 1 and 2) to support clinical and reimbursement decision-making. Curr Med Res Op 2004;20(Suppl. 1):S5–26Includes simulations for nephropathyType 1 and type 2
Archimedes modelEddy DM, Schlessinger L. Archimedes: a trial-validated model of diabetes. Diabetes Care 2003;26:3093–101. URL: http://care​.diabetesjournals​.org/content/26/11/3093.full.pdfNot clear – briefly discusses nephropathy and causesType 1 and type 2
Grima et al. 2007Grima DT, Thompson MF, Sauriol L. Modelling cost effectiveness of insulin glargine for the treatment of type 1 and 2 diabetes in Canada. Pharmacoeconomics 2007;25:253–66Includes ESRD as a stateType 1 and type 2
Copyright © Queen’s Printer and Controller of HMSO 2014. This work was produced by Farmer et al. under the terms of a commissioning contract issued by the Secretary of State for Health. This issue may be freely reproduced for the purposes of private research and study and extracts (or indeed, the full report) may be included in professional journals provided that suitable acknowledgement is made and the reproduction is not associated with any form of advertising. Applications for commercial reproduction should be addressed to: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK.

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Bookshelf ID: NBK261686
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