INCREMENTAL COST OF IMPLEMENTING A CARE PROGRAM FOR PEOPLE WITH TYPE 2 DIABETES IN ARGENTINA

LORENA GONZALEZ; JOAQUIN CAPORALE; JORGE ELGART; JUAN J GAGLIARDINO

Mexico DF

Congreso; 3rd LATIN AMERICA CONFERENCE; 2011

OBJECTIVES: to estimate the incremental cost of implementing a care program for people with type 2 diabetes in Argentina. METHODS: ALAD guidelines were used to identify resources necessary to implement a diabetes care program in two Argentinean provinces with opposite socioeconomic characteristics (Cordoba and Misiones). Microcosting techniques were employed to estimate this cost from a public payer perspective, and considering a province without such diabetes program. Probabilistic sensitivity analysis following Monte Carlo simulation was used to determine the number of visits and practices, probability of insulin treatment, combined drug therapy for hypertension, dislipidemia, annual number of test strips for self-monitoring blood glucose (SMBG) and unit cost. RESULTS: The SMBG represent in both provinces ~50% of the annual incremental cost per patient followed by that of the treatment of hypertension, dyslipidemia and diabetes. The lowest corresponded to human resources ( 90%). Best statistical distribution comparison for incremental costs in C�rdoba and Misiones indicates that: a) Misiones has a 32% average incremental cost lower than C�rdoba; and b) the dispersion around the adjusted mean is greater for Cordoba than for Misiones. The main determinants of incremental costs variation associated to proposed treatment in C�rdoba and Misiones were: a) probability of insulin treatment; b) unitary cost of SMBG strips; c) number of HbA1c determinations; and d) number of strips and lancets needed. The impact of each of these variables would be different in each province. CONCLUSIONS: These data: a) provide the first objective evaluation of the cost of a diabetes program in Argentina, from a public payer perspective and b) identify critical issues to consider when planning the implementation of such a program in places with limited resources.