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Table 3—

Impact of patient complication and treatment utilities on the incremental cost-effectiveness ratio of intensive glucose control versus conventional glucose control in older patients*

Age at onset (years)Incremental cost-effectiveness ratio
Complication utilities
OriginalPatientOriginalPatientOriginalPatient
Treatment utilities
OriginalOriginalPatient, insulinPatient, insulinPatient, oralsPatient, orals
60–65 136 78 (75–81) Dom. Dom. 90 (38–537) 67 (39–209) 
65–70 328 168 (161–176) Dom. Dom. 127 (Dom. −987) 101 (39–670) 
70–75 746 354 (339–371) Dom. Dom. 149 (Dom. −1,470) 127 (Dom. −834) 
75–80 2,284 953 (907–1,006) Dom. Dom. 165 (Dom. −1,200) 152 (Dom. −1,294) 
80–85 7,544 2,852 (2,709–3,019) Dom. Dom. 159 (Dom. −1,602) 152 (Dom. −1,281) 
85–90 24,205 8,912 (8,446–9,449) Dom. Dom. 142 (Dom. −1,190) 134 (Dom. −931) 
Age at onset (years)Incremental cost-effectiveness ratio
Complication utilities
OriginalPatientOriginalPatientOriginalPatient
Treatment utilities
OriginalOriginalPatient, insulinPatient, insulinPatient, oralsPatient, orals
60–65 136 78 (75–81) Dom. Dom. 90 (38–537) 67 (39–209) 
65–70 328 168 (161–176) Dom. Dom. 127 (Dom. −987) 101 (39–670) 
70–75 746 354 (339–371) Dom. Dom. 149 (Dom. −1,470) 127 (Dom. −834) 
75–80 2,284 953 (907–1,006) Dom. Dom. 165 (Dom. −1,200) 152 (Dom. −1,294) 
80–85 7,544 2,852 (2,709–3,019) Dom. Dom. 159 (Dom. −1,602) 152 (Dom. −1,281) 
85–90 24,205 8,912 (8,446–9,449) Dom. Dom. 142 (Dom. −1,190) 134 (Dom. −931) 

Data are means (95% CI) in thousands of dollars/QALY, unless otherwise indicated.

*

Columns 2–7 illustrate the impact of distinct combinations of original and patient utilities on the relative cost-effectiveness of intensive glucose control versus conventional glucose control for hypothetical patients 65–90 years of age at disease onset. Dom., dominated (the alternative therapy is both harmful and more expensive); insulin, utility for intensive glucose control with insulin used; orals, utility for intensive glucose control with oral medications used.

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