PDF(Sci-hub)
Abstract：
BACKGROUND: The elderly diabetes prevalence is greater than 20%. Drug hypoglycemia prevention is the key point in elderly diabetes therapeutic management. Today, there is no better drug to add to metformin in elderly uncontrolled diabetes.
METHODS: A literature review established the different hypoglycemic events and their occurrence probability. After determining the various procedures costs in the hypoglycemic events management and associated treatments costs, the cost of each type of hypoglycemic event (mild, moderate and severe) was calculated and the average cost of an hypoglycemic event (all intensities combined) was deduced. In order to determine the most appropriate drug association in the 80+age group, a cost-utility study was conducted using the quality adjusted life years (QALY) determination of each strategy.
RESULTS: The lower hypoglycemic strategies are metformine+DPP-4 inhibitor and metformin+GLP-1 analogs. Following the calculation of the different ICERs, the most economically and clinically advantageous drug combination is: metformin+DPP-4 inhibitor. DISCUSSION - CONCLUSION: Based on this study, the drug combination metformin+DPP-4 inhibitor would be the better therapy in elderly diabetic patient. However, this result needs to be adapted individually.
METHODS: A literature review established the different hypoglycemic events and their occurrence probability. After determining the various procedures costs in the hypoglycemic events management and associated treatments costs, the cost of each type of hypoglycemic event (mild, moderate and severe) was calculated and the average cost of an hypoglycemic event (all intensities combined) was deduced. In order to determine the most appropriate drug association in the 80+age group, a cost-utility study was conducted using the quality adjusted life years (QALY) determination of each strategy.
RESULTS: The lower hypoglycemic strategies are metformine+DPP-4 inhibitor and metformin+GLP-1 analogs. Following the calculation of the different ICERs, the most economically and clinically advantageous drug combination is: metformin+DPP-4 inhibitor. DISCUSSION - CONCLUSION: Based on this study, the drug combination metformin+DPP-4 inhibitor would be the better therapy in elderly diabetic patient. However, this result needs to be adapted individually.
摘要：
背景：老年人糖尿病患病率大于20%。药物预防低血糖是老年糖尿病治疗管理的关键。今天,在未控制的老年糖尿病中，没有更好的药物来添加二甲双胍。
方法：文献综述建立了不同的低血糖事件及其发生概率。在确定低血糖事件管理中的各种程序成本和相关治疗成本之后，每种类型的低血糖事件的成本(轻度，计算中度和重度),并推导低血糖事件(所有强度组合)的平均成本.为了确定80岁以上年龄组中最合适的药物关联，使用每种策略的质量调整生命年(QALY)测定值进行成本-效用研究.
结果：较低的降血糖策略是二甲双胍+DPP-4抑制剂和二甲双胍+GLP-1类似物。在计算不同的ICER之后，最经济和临床上有利的药物组合是:二甲双胍+DPP-4抑制剂。讨论-结论：基于这项研究，二甲双胍+DPP-4抑制剂联合治疗老年糖尿病患者是较好的治疗方案.然而,这个结果需要单独调整。
方法：文献综述建立了不同的低血糖事件及其发生概率。在确定低血糖事件管理中的各种程序成本和相关治疗成本之后，每种类型的低血糖事件的成本(轻度，计算中度和重度),并推导低血糖事件(所有强度组合)的平均成本.为了确定80岁以上年龄组中最合适的药物关联，使用每种策略的质量调整生命年(QALY)测定值进行成本-效用研究.
结果：较低的降血糖策略是二甲双胍+DPP-4抑制剂和二甲双胍+GLP-1类似物。在计算不同的ICER之后，最经济和临床上有利的药物组合是:二甲双胍+DPP-4抑制剂。讨论-结论：基于这项研究，二甲双胍+DPP-4抑制剂联合治疗老年糖尿病患者是较好的治疗方案.然而,这个结果需要单独调整。
