Gesundheitsökonomische Evaluation von Präventions- und Managementstrategien bei Diabetes

Background: Resources in the healthcare system are limited and the decision for or against certain strategies have opportunity costs. Due to high treatment costs, efficient allocation of resources is of high relevance in the field of diabetes. With the systematic comparison of costs and health effects, economic evaluations provide a framework to answer this question. Objectives: We present an overview on the method of economic evaluation alongside with examples from the field of diabetes to improve the understanding for the relevance of scientific studies. Materials and methods: In the literature, cost utility analysis is the most frequent form of efficiency evaluation. It compares the costs and health effects of alternative strategies. In practice, economic evaluations often augment data from clinical studies with model-based simulations; in the field of diabetes it is also important to have a long-term time horizon, to account for discounting and to fully capture all relevant cost components. Results and discussion: The predominantly international evidence shows that intensified control of blood pressure and blood glucose as well as environmental and fiscal measures are cost-effective or dominant (more effective, less costly) strategies. In addition to evidence on efficiency, many other aspects are important for resource allocation and efficiency considerations play only a subordinated role in the German health care system. To exploit the full potential of economic evaluations it is important to integrate health economic considerations already into the planning phase of intervention studies.