| dc.contributor.advisor | Τάλιας, Μιχαήλ | |
| dc.contributor.author | Ιωάννου, Σάββας | |
| dc.contributor.other | Ioannou, Savvas | |
| dc.coverage.spatial | Κύπρος | el_GR |
| dc.date.accessioned | 2014-09-29 | |
| dc.date.accessioned | 2014-09-29T07:46:58Z | |
| dc.date.available | 2014-09-29T07:46:58Z | |
| dc.date.copyright | 2014-07 | |
| dc.date.issued | 2014-09-29 | |
| dc.identifier.other | ΔΜΥ/2014/00249 | el_GR |
| dc.identifier.uri | http://hdl.handle.net/11128/1734 | |
| dc.description | Περιέχει βιβλιογραφικές παραπομπές. | el_GR |
| dc.description.abstract | ------- | el_GR |
| dc.format.extent | xi, 132 σ. εικ., 30 εκ. | el_GR |
| dc.language | gr | el_GR |
| dc.language.iso | gr | el_GR |
| dc.rights | info:eu-repo/semantics/closedAccess | el_GR |
| dc.subject | Οικονομική Αξιολόγηση Τεχνολογιών Υγείας | el_GR |
| dc.subject | Αξιολόγηση Τεχνολογιών Υγείας | el_GR |
| dc.subject | Economic Evaluation of Health Technology Assessment | el_GR |
| dc.subject | Health Technology Assessment | el_GR |
| dc.title | Αξιολόγηση Τεχνολογιών Υγείας: Η οικονομική αξιολόγηση α) της σιταγλιπτίνης ως προσθήκη στα θεραπευτικά σχήματα που περιέχουν μετφορμίνη, γλιμπενκλαμίδη ή γλιμεπιρίδη και β) της ινσουλίνης glargine ως αντικατάσταση μιας ενδιάμεσου δράσης ινσουλίνης (ισοφανικής ινσουλίνης NPH ή διφασικής ισοφανικής ινσουλίνης 30/70) στο σύστημα υγείας της Κύπρου | el_GR |
| dc.type | Μεταπτυχιακή Διατριβή | el_GR |
| dc.description.translatedabstract | Background The cost of a medical product in itself cannot be a criterion for its adoption by a Health System. In any economic evaluation of an individual treatment, the cost of side effects and possible patient complications should be taken into account. Aim The overall aim of the study was the economic evaluation in terms of cost-effectiveness: a) of sitagliptin as an add-on to regimens containing biguanide (metformin) and sulfonylurea (glibenclamide or glimepiride) and b) of insulin glargine (long acting insulin) as a replacement for an intermediate-acting insulin (isophane insulin NPH or biphasic isophane insulin 30/70) in regimens containing metformin and insulin Actrapid/Humulin R or insulin Glulisine. Methods Between May 2013 and November 2013, a randomized clinical study was undertaken at two general hospitals in Cyprus (Larnaca General Hospital and General Hospital Famagusta). The UKPDS Outcomes Model of the University of Oxford was applied to 100 patients on sitagliptin and 100 patients on insulin glargine three months before and three months after the addition of sitagliptin or insulin glargine. All patients had Type 2 diabetes, were aged 18 years or older and excluded pregnant or nursing women. Results
Evaluation in terms of cost-effectiveness showed that the enhanced regimens with sitagliptin + metformin (€11023.81/QALY) and sitagliptin + metformin + sulfonylurea (€-332927/QALY) were cost-effective in comparison to metformin + sulfonylurea. It demonstrated for the first time that treatment with sitagliptin + metformin + sulfonylurea compares favourably in cost-effectiveness to treatment with sitagliptin + metformin. Treatments Glargine + Actrapid/Humulin R (€8845.09/QALY) and Glargine + Glulisine (€-8242.18/QALY) were cost-effective compared to isophane insulin NPH. All three regimens, Glargine + Actrapid/Humulin R (€7519.40/QALY), Glargine + Glulisine (€7831.39/QALY) and Glargine (€-7097.48/QALY), were cost-effective in relation to the insulin 30/70. All cost-effective treatments showed statistically significant reductions in glycosylated hemoglobin HbA1c and breakfast sugar over previous treatments. The sitagliptin + metformin
xi
showed a reduction in the total number of hypoglycemic events (p <0.001) and the number of nocturnal hypoglycemic events (p=0.001) versus metformin + sulfonylurea. There was no statistically significant difference in relation to weight gain or loss, total number of hypoglycaemic episodes, the number of nocturnal hypoglycaemic episodes or the number of hypoglycaemic episodes requiring hospitalization before and after the change to all other regimens. Conclusions The study indicated that treatments with sitagliptin + metformin and sitagliptin + metformin + sulfonylurea compared to treatment with sitagliptin + sulfonylurea, and all combinations of the insulin glargine examined as a replacement for NPH insulin or insulin 30/70, were cost-effective. | el_GR |
| dc.format.type | pdf | el_GR |
