- Alastair Gray, director ()a,
- Philip Clarke, research fellowa,
- Andrew Farmer, NHSE R&D clinical scientistb,
- Rury Holman, directorc on behalf of the United Kingdom Prospective Diabetes Study (UKPDS) Group
- aHealth Economics Research Centre, Department of Public Health, University of Oxford, Institute of Health Sciences, Oxford OX3 7LF
- bDepartment of Primary Health Care, University of Oxford, Institute of Health Sciences
- cDiabetes Trials Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford OX2 6HE
- Correspondence to: A Gray
- Accepted 16 July 2002
Objective: To estimate the incremental cost of implementing policies for intensive control of blood glucose concentration and blood pressure for all patients with type 2 diabetes in England.
Design: Extrapolation of resource use and cost data derived from a randomised controlled trial.
Setting: General practice, outpatient care, and inpatient care.
Population: Trial population with diagnosed type 2 diabetes in England extrapolated to the population of England.
Main outcome measures: Total costs based on use of healthcare resources including costs of management, treatment, and hospitalisation.
Results: The incremental net annual cost of implementing intensive control of blood glucose and blood pressure to all people with diagnosed type 2 diabetes in England is estimated to be £100.5m ($156m; €159m), which is equivalent to less than 1% of the proposed additional annual expenditure on the NHS in 2001-5. This estimate varied in sensitivity analyses from £67m to £121m.
Conclusions: Policies to improve control of blood glucose and blood pressure of people with type 2 diabetes are effective in reducing complications associated with the disease and are also cost effective. The total cost represents a small fraction of the NHS's spending plans.
Funding The major grants for the United Kingdom Prospective Diabetes Study were from the UK Medical Research Council, British Diabetic Association, the UK Department of Health, the National Eye Institute and the National Institute of Digestive, Diabetes, and Kidney Disease in the National Institutes of Health (United States), the British Heart Foundation, Novo-Nordisk, Bayer, Bristol Myers Squibb, Hoechst, Eli Lilly, Lipha, and Farmitalia Carlo Erba. We thank Glaxo Wellcome, SmithKline Beecham, Pfizer, Zeneca, Pharmacia Upjohn, Novo Nordisk, Bayer, Roche, and the UK Department of Health for grants for this health economics study. Other funding companies and agencies, the supervising committees, and all participating staff are listed in an earlier paper (Lancet 1998;352:837-53).
Competing interests Competing interests: RH has received research monies for members of staff and fees for consulting from a number of pharmaceutical companies. AG has received support for attending conferences from Lipha and GlaxoSmithKline. Reprint requests to: UKPDS Group, Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Infirmary, Woodstock Road, Oxford, OX2 6HE