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Abushanab D, Al-Badriyeh D, Marquina C, Liew D, Al-Zaidan M, Ghaith Al-Kuwari M, Abdulmajeed J, Ademi Z. Societal health and economic burden of cardiovascular diseases in the population with type 2 diabetes in Qatar. A 10-year forecasting model. Diabetes Obes Metab 2024; 26:148-159. [PMID: 37845584 DOI: 10.1111/dom.15299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/04/2023] [Accepted: 09/13/2023] [Indexed: 10/18/2023]
Abstract
AIMS To predict the future health and economic burden of cardiovascular disease (CVD) in type 2 diabetes (T2D) in Qatar. MATERIALS AND METHODS A dynamic multistate model was designed to simulate the progression of fatal and non-fatal CVD events among people with T2D in Qatar aged 40-79 years. First CVD events [i.e. myocardial infarction (MI) and stroke] were calculated via the 2013 Pooled Cohort Equation, while recurrent CVD events were sourced from the REACH registry. Key model outcomes were fatal and non-fatal MI and stroke, years of life lived, quality-adjusted life years, total direct medical costs and total productivity loss costs. Utility and cost model inputs were drawn from published sources. The model adopted a Qatari societal perspective. Sensitivity analyses were performed to test the robustness of estimates. RESULTS Over 10 years among people with T2D, model estimates 108 195 [95% uncertainty interval (UI) 104 249-112 172] non-fatal MIs, 62 366 (95% UI 60 283-65 520) non-fatal strokes and 14 612 (95% UI 14 472-14 744) CVD deaths. The T2D population accrued 4 786 605 (95% UI 4 743 454, 4 858 705) total years of life lived and 3 781 833 (95% UI 3 724 718-3 830 669) total quality-adjusted life years. Direct costs accounted for 57.85% of the total costs, with a projection of QAR41.60 billion (US$11.40 billion) [95% UI 7.53-147.40 billion (US$2.06-40.38 billion)], while the total indirect costs were expected to exceed QAR30.31 billion (US$8.30 billion) [95% UI 1.07-162.60 billion (US$292.05 million-44.55 billion)]. CONCLUSIONS The findings suggest a significant economic and health burden of CVD among people with T2D in Qatar and highlight the need for more enhanced preventive strategies targeting this population group.
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Affiliation(s)
- Dina Abushanab
- Health Economics and Policy Evaluation Research (HEPER) Group Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia
| | | | - Clara Marquina
- Health Economics and Policy Evaluation Research (HEPER) Group Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia
| | - Danny Liew
- The Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Manal Al-Zaidan
- Department of Pharmacy and Therapeutics Supply, Primary Healthcare Corporation, Doha, Qatar
| | | | - Jazeel Abdulmajeed
- Strategy Planning & Health Intelligence, Primary Healthcare Corporation, Doha, Qatar
| | - Zanfina Ademi
- Health Economics and Policy Evaluation Research (HEPER) Group Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Lai J, Basford JR, Pittelkow MR. Levels of secretory leukocyte protease inhibitor expression in acute wounds. J Wound Care 2022; 31:S15-S19. [PMID: 35797252 DOI: 10.12968/jowc.2022.31.sup7.s15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Even with our best practices, we are frequently unable to prevent slow and stalled wound healing-particularly in people with impaired circulation and conditions such as diabetes. As a result, greater insight into the nature of wound healing and alternative treatment approaches is needed. An avenue that may be of particular promise is increasing understanding of the role of secretory leukocyte protease inhibitor (SLPI) as there is evidence that it enhances wound healing, its expression increases in response to inflammation and infection, and it exhibits anti-protease, anti-inflammatory, antiviral antibacterial and antifungal activities. METHOD The response of SLPI levels to wounding and skin injury was assessed by taking punch skin biopsies from healthy volunteers and assessing the levels of SLPI at the site of injury at the time of wounding (baseline) as well as one, two, three, four, seven, nine and 12 weeks later. RESULTS A total of 35 volunteers took part in the study. Significant elevations were found: levels of SLPI were greatly increased, 12 times that at baseline, and remained elevated at three weeks despite re-epithelialisation having occurred. CONCLUSION These findings not only suggest that levels of SLPI rise rapidly following wounding, but that these elevations are sustained, and continue to increase even when re-epithelialisation has occurred. These results suggest that the role and potential benefits of this protease inhibitor deserve further exploration.
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Affiliation(s)
- Jengyu Lai
- Department of Dermatology, Mayo Clinic College of Medicine, Rochester, MN, US.,International University of the Health Sciences, St Kitts, West Indies
| | - Jeffrey R Basford
- Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine, Rochester, MN, US
| | - Mark R Pittelkow
- Department of Dermatology, Mayo Clinic College of Medicine, Rochester, MN, US
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Alowayesh MS, Aljunid SM, Al-Adsani A, Alessa T, Alattar A, Alroudhan D. Utilization and cost of drugs for diabetes and its comorbidities and complications in Kuwait. PLoS One 2022; 17:e0268495. [PMID: 35653361 PMCID: PMC9162372 DOI: 10.1371/journal.pone.0268495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 05/03/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Diabetes imposes a large burden on countries’ healthcare expenditures. In Kuwait, diabetes prevalence in adults is estimated at 22.0%%—double the worldwide prevalence (9.3%). There is little current data on pharmaceutical costs in Kuwait of managing diabetes and diabetes-related complications and comorbidities.
Objectives
Estimate the utilization and cost of drugs for diabetes and diabetes-related complications and comorbidities in Kuwait for year 2018, as well determinants of costs.
Methods
This cross-sectional study used a multi-stage stratified sampling method. Patients were Kuwaiti citizens with diabetes, aged 18–80, recruited from all six governorates. Physicians collected demographic data, clinical data, and current drug prescription for each patient which was extrapolated for the full year of 2018. A prevalence-based approach and bottom-up costing were used. Data were described according to facility type (primary care vs. hospital). A generalized linear model with log function and normal distribution compared drug costs for patients with and without comorbidities/complications after adjustments for demographic and health confounders (gender, age group, disease duration, and obesity).
Results
Of 1182 diabetes patients, 64.0% had dyslipidemia and 57.7% had hypertension. Additionally, 40.7% had diabetes-related complications, most commonly neuropathy (19.7%). Of all diabetes patients, 85.9% used oral antidiabetics (alone or in combinations), 49.5% used insulin alone or in combinations, and 29.3% used both oral antidiabetics and insulin. The most frequently used oral drug was metformin (75.7%), followed by DPP4 inhibitors (40.2%) and SGLT2 inhibitors (23.8%). The most frequently used injectables were insulin glargine (36.6%), followed by GLP-1 receptor agonists (15.4%). Total annual drug cost for Kuwait’s diabetic population for year 2018 was US$201 million (US$1,236.30 per patient for antidiabetics plus drugs for comorbidities/complications).
Conclusions
Drug costs for treating diabetes and comorbidities/complications accounted for an estimated 22.8% of Kuwait’s 2018 drug expenditures. Comorbidities and complications add 44.7% to the average drug cost per diabetes patient.
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Affiliation(s)
- Maryam S. Alowayesh
- Department of Pharmacy Practice, School of Pharmacy, Kuwait University, Jabriyah, Kuwait
- * E-mail:
| | - Syed M. Aljunid
- Department of Health Policy and Management, School of Public Health, Kuwait University, Jabriyah, Kuwait
| | - Afaf Al-Adsani
- Al-Sabah Hospital, Ministry of Health, Kuwait City, Kuwait
| | - Thamer Alessa
- Jaber Al-Ahmed Hospital, Ministry of Health, Kuwait City, Kuwait
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Suleiman N, Alkasem M, Hassoun S, Abdalhakam I, Bettahi I, Mir F, Ramanjaneya M, Jerobin J, Iskandarani A, Samra TA, Chandra P, Skarulis M, Abou-Samra AB. Insulin sensitivity variations in apparently healthy Arab male subjects: correlation with insulin and C peptide. BMJ Open Diabetes Res Care 2021; 9:9/2/e002039. [PMID: 34785564 PMCID: PMC8596034 DOI: 10.1136/bmjdrc-2020-002039] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 06/30/2021] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Decreased insulin sensitivity occurs early in type 2 diabetes (T2D). T2D is highly prevalent in the Middle East and North Africa regions. This study assessed the variations in insulin sensitivity in normal apparently healthy subjects and the levels of adiponectin, adipsin and inflammatory markers. RESEARCH DESIGN AND METHODS A total of 60 participants (aged 18-45, body mass index <28) with a normal oral glucose tolerance test (OGTT) completed hyperinsulinemic-euglycemic clamp (40 mU/m2/min) and body composition test by dual-energy X-ray absorptiometry scan. Blood samples were assayed for glucose, insulin, C peptide, inflammatory markers, oxidative stress markers, adiponectin and adipsin. RESULTS The subjects showed wide variations in the whole-body glucose disposal rate (M value) from 2 to 20 mg/kg/min and were divided into three groups: most responsive (M>12 mg/kg/min, n=17), least responsive (M≤6 mg/kg/min, n=14) and intermediate responsive (M=6.1-12 mg/kg/min, n=29). Insulin and C peptide responses to OGTT were highest among the least insulin sensitive group. Triglycerides, cholesterol, alanine transaminase (ALT) and albumin levels were higher in the least responsive group compared with the other groups. Among the inflammatory markers, C reactive protein (CRP) was highest in the least sensitivity group compared with the other groups; however, there were no differences in the level of soluble receptor for advanced glycation end products and Tumor Necrosis Factor Receptor Superfamily 1B (TNFRS1B). Plasma levels of insulin sensitivity markers, adiponectin and adipsin, and oxidative stress markers, oxidized low-density lipoprotein, total antioxidant capacity and glutathione peroxidase 1, were similar between the groups. CONCLUSIONS A wide range in insulin sensitivity and significant differences in triglycerides, cholesterol, ALT and CRP concentrations were observed despite the fact that the study subjects were homogenous in terms of age, gender and ethnic background, and all had normal screening comprehensive chemistry and normal glucose response to OGTT. The striking differences in insulin sensitivity reflect differences in genetic predisposition and/or environmental exposure. The low insulin sensitivity status associated with increased insulin level may represent an early stage of metabolic abnormality.
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Affiliation(s)
- Noor Suleiman
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar
| | - Meis Alkasem
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar
| | - Shaimaa Hassoun
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar
| | | | - Ilham Bettahi
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar
- Interim Translational Research Institute, Hamad Medical Corporation, Doha, Qatar
| | - Fayaz Mir
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar
- Interim Translational Research Institute, Hamad Medical Corporation, Doha, Qatar
| | - Manjunath Ramanjaneya
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar
- Interim Translational Research Institute, Hamad Medical Corporation, Doha, Qatar
| | - Jayakumar Jerobin
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar
- Interim Translational Research Institute, Hamad Medical Corporation, Doha, Qatar
| | - Ahmad Iskandarani
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar
- Interim Translational Research Institute, Hamad Medical Corporation, Doha, Qatar
| | - Tareq A Samra
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar
- Interim Translational Research Institute, Hamad Medical Corporation, Doha, Qatar
| | - Prem Chandra
- Medical Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Monica Skarulis
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar
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First-line Treatment with Empagliflozin and Metformin Combination Versus Standard Care for Patients with Type 2 Diabetes Mellitus and Cardiovascular Disease in Qatar. A Cost-Effectiveness Analysis. Curr Probl Cardiol 2021; 47:100852. [PMID: 33992426 DOI: 10.1016/j.cpcardiol.2021.100852] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 03/27/2021] [Indexed: 12/15/2022]
Abstract
Sodium-glucose cotransporter 2 (SGLT2) inhibitors have shown to reduce cardiovascular events and mortality in patients with type 2 diabetes mellitus (T2DM), but they are currently not used as first-line therapy in clinical practice. This study sought to evaluate the cost-effectiveness of first-line empagliflozin plus standard care for patients with newly diagnosed T2DM and existing cardiovascular disease (CVD). A decision-analytic Markov model with one-year cycles and a lifetime time horizon was developed from the perspective of the Qatari healthcare system to compare first-line empagliflozin combined with metformin versus metformin monotherapy for patients aged 50 to 79 years with T2DM and existing CVD. Two health states were considered: 'Alive with CVD and T2DM' and 'Dead'. Patients could experience non-fatal myocardial infarction, non-fatal stroke, hospitalization for heart failure, hospitalization for unstable angina, and cardiovascular or non-cardiovascular death. Model inputs were ascertained from published and publicly available sources in Qatar. Costs and outcomes were discounted at 3% per annum. Sensitivity analyses were conducted to evaluate parameter uncertainty. The model predicted that adding empagliflozin to current standard care led to additional 1.9 years of life saved (YoLS) and 1.5 quality-adjusted life year (QALYs) per person, and an incremental cost of QAR 56,869 (USD 15,619), which equated to an incremental cost-effectiveness ratio of QAR 30,675 (USD 8,425) per YoLS and QAR 39,245 (USD 10,779) per QALY. Sensitivity analyses showed the findings to be robust. First-line empagliflozin combined with metformin appears to be a cost-effective therapeutic option for patients with T2DM and CVD.
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Abstract
OBJECTIVE To assess the association between dietary patterns and glycaemic control among Qatari adults with type 2 diabetes (T2DM). DESIGN Cross-sectional analysis using data from the Qatar Biobank Study. Poor glycaemic control was defined as HbA1c ≥7·0 %. Dietary patterns were constructed using factor analysis based on habitual food intake assessed by a FFQ. Medication use was based on self-report. Multivariable logistic regression was used to assess the association. SETTING Qatar. PARTICIPANTS Adults aged ≥18 years (n 1000) with known diabetes. RESULT The mean age of the participants was 52·3 (sd 11·5) years. Overall, the prevalence of poor glycaemic control was 57·6 %, and 27·7 % of the participants were insulin users. Three dietary patterns were identified. The modern dietary pattern (high intake of fast food, croissants, white bread and cheese) was inversely associated with poor glycaemic control. The sd increments of the modern pattern had OR for poor glycaemic control of 0·86 (95 % CI 0·68, 1·08) in men and 0·76 (95 % CI 0·61, 0·95) in women. There was a significant interaction between the modern pattern and diabetes medication in men but not in women. In men without diabetes medication, the modern pattern was positively associated with poor glycaemic control with an OR of 2·35 (95 % CI 1·13, 4·87). CONCLUSIONS Male diabetes patients took medication to control diabetes but ate more unhealthy food. In men who were not taking diabetes medication, modern dietary pattern was associated with poor glycaemic control. Promoting healthy eating should be encouraged especially among those under diabetes medication.
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Ansari-Moghaddam A, Setoodehzadeh F, Khammarnia M, Adineh HA. Economic cost of diabetes in the Eastern Mediterranean region countries: A meta-analysis. Diabetes Metab Syndr 2020; 14:1101-1108. [PMID: 32653635 DOI: 10.1016/j.dsx.2020.06.044] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 06/18/2020] [Accepted: 06/19/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND AIMS Non communicable diseases including diabetes imposes substantial financial burden on households, societies and nations in both developed and developing countries. However, there is no information on the extent of diabetes expenditure in the Eastern Mediterranean Region (EMRO). Therefore, this study aimed to identify the treatment costs of diabetes in this area. To our knowledge, this is the first systematic review on treatment expenditures of diabetes in EMRO countries. METHODS A comprehensive literature search was conducted in PUBMED, MEDLINE, EMBASE, SCOPUS and WEB OF SCIENCES databases to find out published manuscripts on treatment cost of diabetes. Information was extracted using data extraction sheets and then the data were imported into STATA software version.11. Mean annual treatment cost of diabetes per patient, annual treatment costs of diabetes per patient by Diabetes Mellitus (DM) complications and finally, cost of chronic diabetes complications per patient were pooled and reported. RESULTS After reviewing title, abstract and the full text of identified articles; a total of seven studies were reported appropriate data for this meta-analysis. The pooled annual treatment cost per diabetes patient for EMRO countries was 1150 US$ (95% CI: 595-2221) which was 3358 US$ (95% CI: 2200-5124) in EMRO countries except of Iran compared to 255 US$ (92-708) in Iran. The treatment cost of diabetes was higher in males, insulin-used and in the patient with family history of diabetes. The cost of diabetes was significantly increased with the duration of diabetes (P = 0.001) as well. According to the results, the largest share of costs is related to medication costs. Finally, the pooled average annual treatment cost per patient by diabetes mellitus complications was varied from 2828 US$ in the patients that have cerebrovascular disease complication to 7261 US$ in the patients with Stroke complication. CONCLUSIONS This study demonstrated that the annual treatment cost of diabetes is varied within EMRO countries. Qatar and Iran have spent the highest and lowest cost for diabetes, respectively. This may be due to the large socioeconomic differences between countries and special conditions of them such as currency value in the region.
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Affiliation(s)
| | - Fatemeh Setoodehzadeh
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.
| | - Mohammad Khammarnia
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Hossein Ali Adineh
- Department of Epidemiology and Biostatistics, Iranshahr University of Medical Sciences, Iranshahr, Iran
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Ponirakis G, Elhadd T, Chinnaiyan S, Dabbous Z, Siddiqui M, Al-Muhannadi H, Petropoulos IN, Khan A, Ashawesh KAE, Dukhan KMO, Mahfoud ZR, Murgatroyd C, Slevin M, Malik RA. Prevalence and management of diabetic neuropathy in secondary care in Qatar. Diabetes Metab Res Rev 2020; 36:e3286. [PMID: 31913560 DOI: 10.1002/dmrr.3286] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 12/12/2019] [Accepted: 12/30/2019] [Indexed: 12/24/2022]
Abstract
AIMS Diabetic neuropathy (DN) is a "Cinderella" complication, particularly in the Middle East. A high prevalence of undiagnosed DN and those at risk of diabetic foot ulceration (DFU) is a major concern. We have determined the prevalence of DN and its risk factors, DFU, and those at risk of DFU in patients with type 2 diabetes mellitus (T2DM) in secondary care in Qatar. MATERIALS AND METHODS Adults with T2DM were randomly selected from the two National Diabetes Centers in Qatar. DN was defined by the presence of neuropathic symptoms and a vibration perception threshold (VPT) ≥ 15 V. Participants with a VPT ≥ 25 V were categorized as high risk for DFU. Painful DN was defined by a DN4 score ≥4. Logistic regression analysis was used to identify predictors of DN. RESULTS In 1082 adults with T2DM (age 54 ± 11 years, duration of diabetes 10.0 ± 7.7 years, 60.6% males), the prevalence of DN was 23.0% (95% CI, 20.5%-25.5%) of whom 33.7% (95% CI, 27.9%-39.6%) were at high risk of DFU, and 6.3% had DFU; 82.0% of the patients with DN were previously undiagnosed. The prevalence of DN increased with age and duration of diabetes and was associated with poor glycaemic control (HbA1c ≥ 9%) AOR = 2.1 (95% CI, 1.3-3.2), hyperlipidaemia AOR = 2.7 (95% CI, 1.5-5.0), and hypertension AOR = 2.0 (95% CI, 1.2-3.4). CONCLUSIONS Despite DN affecting 23% of adults with T2DM, 82% had not been previously diagnosed with one-third at high risk for DFU. This argues for annual screening and identification of patients with DN. Furthermore, we identify hyperglycaemia, hyperlipidaemia, and hypertension as predictors of DN.
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Affiliation(s)
- Georgios Ponirakis
- Weill Cornell Medicine-Qatar, Qatar Foundation, Education City, Doha, Qatar
- Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK
| | - Tarik Elhadd
- National Diabetes Center, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
- National Diabetes Center, Al-Wakra Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Subitha Chinnaiyan
- National Diabetes Center, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Zeinab Dabbous
- National Diabetes Center, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Mashhood Siddiqui
- National Diabetes Center, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Hamad Al-Muhannadi
- Weill Cornell Medicine-Qatar, Qatar Foundation, Education City, Doha, Qatar
| | | | - Adnan Khan
- Weill Cornell Medicine-Qatar, Qatar Foundation, Education City, Doha, Qatar
| | - Khaled A E Ashawesh
- National Diabetes Center, Al-Wakra Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Khaled M O Dukhan
- National Diabetes Center, Al-Wakra Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Ziyad R Mahfoud
- Weill Cornell Medicine-Qatar, Qatar Foundation, Education City, Doha, Qatar
| | | | - Mark Slevin
- Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK
| | - Rayaz A Malik
- Weill Cornell Medicine-Qatar, Qatar Foundation, Education City, Doha, Qatar
- Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK
- National Diabetes Center, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
- Institute of Cardiovascular Science, University of Manchester, Manchester, UK
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Eljilany I, El-Dahiyat F, Curley LE, Babar ZUD. Evaluating quantity and quality of literature focusing on health economics and pharmacoeconomics in Gulf Cooperation Council countries. Expert Rev Pharmacoecon Outcomes Res 2018; 18:403-414. [PMID: 29779401 DOI: 10.1080/14737167.2018.1479254] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND The importance of pharmacoeconomics and health economics has been augmented. It has the potential to provide evidence to aid in optimal decision-making in the funding of cost-effective medicines and services in Gulf Cooperation Council countries (G.C.C). OBJECTIVE To evaluate the quality and quantity of health economic researches published until the end of 2017 in G.C.C. and to identify the factors that affect the quality of studies. METHOD Studies were included according to predefined inclusion and exclusion criteria. The quantity was recorded, and the quality was assessed using the Quality of Health Economic Studies (QHES) instrument. RESULTS Forty-nine studies were included. The mean (SD) quality score of all studies was 57.83 (25.05), and a high number of reviewed studies (47%) were evaluated as either poor or extremely poor quality. The factors that affect the quality of studies with statistical significance were, the type and method of economic evaluation, the economic outcome was the objective of the research, author`s background, the perspective of the study, health intervention and source of funding. CONCLUSION The use of economic evaluation studies in G.C.C was limited. Different factors that affect the quality of articles such as performing a full economic evaluation and choosing societal perspective were identified. Strategies to improve the quality of future studies were recommended.
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Affiliation(s)
- Islam Eljilany
- a Independent Researcher , Pharmacoeconomics Expert , Qatar
| | - Faris El-Dahiyat
- b College of Pharmacy , Al Ain University of Science and Technology , Al Ain , United Arab Emirates
| | - Louise Elizabeth Curley
- c School of Pharmacy, Faculty of Medical and Health Sciences , The University of Auckland , Auckland , New Zealand
| | - Zaheer-Ud-Din Babar
- c School of Pharmacy, Faculty of Medical and Health Sciences , The University of Auckland , Auckland , New Zealand.,d Department of Pharmacy , University of Huddersfield , Huddersfield , United Kingdom
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Linagliptin versus sitagliptin in patients with type 2 diabetes mellitus: a network meta-analysis of randomized clinical trials. ACTA ACUST UNITED AC 2017; 25:23. [PMID: 29070077 PMCID: PMC5655990 DOI: 10.1186/s40199-017-0189-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 10/02/2017] [Indexed: 01/19/2023]
Abstract
Background Diabetes is one of the most common chronic and costly diseases worldwide and type 2 diabetes is the most common type which accounts for about 90% of cases with diabetes. New medication-therapy regimens such as those containing linagliptin alone or in combination with other medications (within the category of DDP-4 inhibitors) must be evaluated in terms of efficacy and compared with other currently used drugs and then enter the medication list of the country. Hence, this study aimed to compare the clinical efficacy of the two drugs, i.e. linagliptin and sitagliptin, in patients with type 2 diabetes. Methods A systematic review was conducted to identify all clinical trials published by 2015 which compared the two drugs in patients with type 2 diabetes. Using keywords such as “linagliptin”, “type 2 diabetes mellitus”, “sitagliptin” and related combinations, we searched databases including Scopus, PubMed, and Web of Science. The quality of the selected studies was evaluated using the Jadad score. Considering primary and secondary outcomes extracted from the reviewed studies, a network meta-analysis was used to conduct a systematic comparison between the two studied drugs. Results This network meta-analysis included 32 studies (Linagliptin vs PLB: n = 8, Sitagliptin vs PLB: n = 13, Linagliptin + MET vs PLB + MET: n = 4, and Sitagliptin + MET vs PLB + MET: n = 7) and a total of 13,747 patients. The results showed no significant difference between linagliptin and sitagliptin in terms of key efficacy and safety outcomes such as HbA1c changes from baseline, body weight change from baseline, percentage of patients achieving HbA1c <7, and percentage of patients experiencing hypoglycemic events (p > 0.05). The results showed that the efficacy of the two drug regimens was the same. Conclusions Based on the results, there was no significant difference between the two drugs, i.e. linagliptin and sitagliptin, in terms of efficacy; in other words, the efficacy of the two drugs was the same. Therefore, the use of these two drugs depends on their availability and cost. Graphical abstract Graphical abstract of the network meta-analysis performed to evaluate the alternatives under the study.![]() Electronic supplementary material The online version of this article (10.1186/s40199-017-0189-6) contains supplementary material, which is available to authorized users.
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