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hal.structure.identifierLaboratoire d'Economie de Dauphine [LEDa]
dc.contributor.authorLévy, Pierre
HAL ID: 10931
hal.structure.identifierHôpital d'Instruction des Armées Begin
dc.contributor.authorBordier, Lyse
hal.structure.identifier
dc.contributor.authorCalvet, Jean-Henri
hal.structure.identifier
dc.contributor.authorLe Hérissé, Gaëlle
hal.structure.identifierHôpital d'Instruction des Armées Begin
dc.contributor.authorBauduceau, Bernard
dc.date.accessioned2017-01-17T14:56:34Z
dc.date.available2017-01-17T14:56:34Z
dc.date.issued2015
dc.identifier.issn2155-6156
dc.identifier.urihttps://basepub.dauphine.fr/handle/123456789/16173
dc.language.isoenen
dc.subjectMicrovascular complicationsen
dc.subjectDiabetic autonomicneuropathyen
dc.subjectSudomotor functionen
dc.subjectPrevention programen
dc.subject.ddc334en
dc.subject.classificationjelI.I1.I18en
dc.titlePotential Budgetary Impact of Large Scale Screening of Small Fiber Neuropathy in the Follow-Up of Patients with Type 2 Diabetes in Franceen
dc.typeArticle accepté pour publication ou publié
dc.description.abstractenAims: The burden of diabetes-related complications is important and increasing in France. Early screening of microvascular complications could avoid the occurrence of more severe consequences. An economic model using a 5-year time horizon was developed to estimate the potential impact in France of large screening of diabetic autonomic neuropathy using Sudoscan, a quick, non-invasive and quantitative method developed for screening of small fiber neuropathy. Methods: A disease progression model was first developed to describe the long-term evolution of patients with type 2 diabetes regarding microvascular complications over successive time periods and patients were classified in 4 groups according to the severity. Complication-related costs were then calculated for a cohort of patients treated according to the current pattern of care and compared with the costs incurred by the same cohort assuming the introduction and widespread use of a large screening of small fiber neuropathy using the Sudoscan method. Comparison of treatment costs between the two situations was used to evaluate the potential budget impact of such a prevention policy in France. Results: According to this general screening of early complications more than 25,000 patients could avoid more severe complications. The gross benefit of such a new prevention strategy would be around € 280 million at 5th year. After 5 years of follow-up, the cumulated gross benefit would be € 837 million and in the worst case scenario (decrease of 20% for each uncertain parameter, namely the distribution of patients among severity groups, the death rates in each severity group, and the distribution of newly diagnosed patients in each severity group) gross benefit would remain at more than € 50 million for the first year and more than € 255 million at the 5th year (using 6% as global efficacy of screening method as basal value). Conclusion: Large screening of small fiber neuropathy could avoid more severe peripheral neuropathy and consequently decrease the burden related to such complications for a limited investment.en
dc.relation.isversionofjnlnameJournal of Diabetes & Metabolism
dc.relation.isversionofjnlvol6en
dc.relation.isversionofjnlissue10en
dc.relation.isversionofjnldate2015
dc.relation.isversionofdoi10.4172/2155-6156.1000618en
dc.relation.isversionofjnlpublisherOMICS Internationalen
dc.subject.ddclabelEconomie socialeen
dc.relation.forthcomingnonen
dc.relation.forthcomingprintnonen
dc.description.ssrncandidatenonen
dc.description.halcandidateouien
dc.description.readershiprechercheen
dc.description.audienceInternationalen
dc.relation.Isversionofjnlpeerreviewedouien
dc.relation.Isversionofjnlpeerreviewedouien
dc.date.updated2016-12-15T09:01:58Z
hal.identifierhal-01438321*
hal.version1*
hal.update.actionupdateFiles*
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