Abstract
In this paper, we assess the cost-effectiveness of 1 g daily of carnosine (an over the counter supplement) in addition to standard care for the management of type 2 diabetes and compare it to standard care alone. Dynamic multistate life table models were constructed in order to estimate both clinical outcomes and costs of Australians aged 18 years and above with and without type 2 diabetes over a ten-year period, 2020 to 2029. The dynamic nature of the model allowed for population change over time (migration and deaths) and accounted for the development of new cases of diabetes. The three health states were ‘Alive without type 2 diabetes’, ‘Alive with type 2 diabetes’ and ‘Dead’. Transition probabilities, costs, and utilities were obtained from published sources. The main outcome of interest was the incremental cost-effectiveness ratio (ICER) in terms of cost per year of life saved (YoLS) and cost per quality-adjusted life year (QALY) gained. Over the ten-year period, the addition of carnosine to standard care treatment resulted in ICERs (discounted) of AUD 34,836 per YoLS and AUD 43,270 per QALY gained. Assuming the commonly accepted willingness to pay threshold of AUD 50,000 per QALY gained, supplemental dietary carnosine may be a cost-effective treatment option for people with type 2 diabetes in Australia.
Highlights
The prevalence of diabetes is rising and represents an important cause of preventable morbidity and mortality
143,913 years of life lived with the addition of carnosine to standard care
quality-adjusted life year (QALY) were higher in the carnosine group compared to standard care, with a total of
Summary
The prevalence of diabetes is rising and represents an important cause of preventable morbidity and mortality. Untreated diabetes over time can lead to irreversible long-term macrovascular and microvascular complications. The worldwide prevalence of diabetes in 2021 was 10.5%, and is expected to increase to 12.2% by 2045 [1]. In Australia, the age-standardised prevalence of self-reported diabetes increased from 3.3% in 2001 to. Diabetes was associated with 1.2 million hospitalisations in Australia in 2017–2018 [2], the majority due to type 2 diabetes, which is largely preventable. The associated economic costs are significant and opportunities to improve management are abundant. Evidence suggests that 12% of global health expenditure is spent on diabetes [3]
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