Glycated albumin for glycemic control in t2dm population: A multi-dimensional evaluation

Lucrezia Ferrario, Fabrizio Schettini, Angelo Avogaro, Chiara Bellia, Federico Bertuzzi, Graziella Bonetti, Antonio Ceriello, Marcello Ciaccio, Massimiliano Corsi Romanelli, Elena Dozio, Luca Falqui, Angela Girelli, Antonio Nicolucci, Gianluca Perseghin, Mario Plebani, Umberto Valentini, Martina Zaninotto, Silvana Castaldi, Emanuela Foglia

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To investigate the glycated albumin (GA) introduction implications, as an add-on strategy to traditional glycemic control (Hb1Ac and fasting plasma glucose – FPG) instruments, considering insulin-naïve individuals with type 2 diabetes mellitus (T2DM), treated with oral therapies. Methods: A Health Technology Assessment was conducted in Italy, as a multi-dimensional approach useful to validate any innovative technology. The HTA dimensions, derived from the EUnetHTA Core Model, were deployed by means of literature evidence, health economics tools and qualitative questionnaires, filled-in by 15 professionals. Results: Literature stated that the GA introduction could lead to a higher number of individuals achieving therapeutic success after 3 months of therapy (97.0% vs 71.6% without GA). From an economic point of view, considering a projection of 1,955,447 T2DM insulinnaïve individuals, potentially treated with oral therapy, GA introduction would imply fewer individuals requiring a therapy switch (−89.44%), with a 1.06% in costs reduction, on annual basis, thus being also the preferable solution from a cost-effectiveness perspective (costeffectiveness value: 237.74 vs 325.53). According to experts opinions, lower perceptions on GA emerged with regard to equity aspects (0.13 vs 0.72, p-value>0.05), whereas it would improve both individuals (2.17 vs 1.33, p-value=0.000) and caregivers quality of life (1.50 vs 0.83, p-value=0.000). Even if in the short term, GA required additional investments in training courses (−0.80 vs 0.10, p-value = 0.036), in the long run, GA could become the preferable technology (0.30 vs 0.01, p-value=0.018) from an organisational perspective. Conclusion: Adding GA to traditional glycaemic control instruments could improve the clinical pathway of individuals with T2DM, leading to economic and organisational advantages for both hospitals and National Healthcare Systems.

Original languageEnglish
Pages (from-to)453-464
Number of pages12
JournalClinicoEconomics and Outcomes Research
Volume13
DOIs
Publication statusPublished - 2021

Keywords

  • Economic evaluation
  • Glycated albumin
  • Health Technology Assessment
  • Multidimensional approach
  • T2DM
  • Type 2 diabetes mellitus

ASJC Scopus subject areas

  • Economics, Econometrics and Finance (miscellaneous)
  • Health Policy

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