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Table 2 Costs, adjusted to 2016 Mexican and United States currency

From: Cost-effectiveness of the use of the continuous subcutaneous insulin infusion pump versus daily multiple injections in type 1 diabetes adult patients at the Mexican Institute of Social Security

Description of event

Type of treatment

Costs

year-2016 MXN$

Costs

year-2016 USD$

References

T1D

CSII

$53,568.00

$2912.89

Medtronica

MDI

$22,884.97

$1244.42

[23]b

Complications

 Cardiovascular events

Myocardial infarction, year of event

$267,057.59

$14,521.89

[25]c

Myocardial infarction, each subsequent year

$29,673.07

$1613.54

Ψ

Angina, year of onset

$108,136.66

$5880.19

[25]

Angina, each subsequent year

$12,015.18

$653.35

Ψ

Congestive heart failure, year of onset

$155,593.67

$8460.78

[25]

Congestive heart failure, each subsequent year

$17,288.19

$940.09

Ψ

Stroke, year of event

$41,540.56

$2258.87

[25]d

Stroke, each subsequent year

$4615.62

$250.99

Ψ

Stroke death within 30 days

$41,104.86

$2235.17

[25]

Peripheral vascular disease, year of onset

$83,605.69

$4546.26

[25]

Peripheral vascular disease, each subsequent year

$9289.52

$505.14

Ψ

 Renal complications

Hemodialysis, year of onset

$434,803.79

$23,643.49

[24]e

Hemodialysis, each subsequent year

$351,393.12

$19,107.84

[24]

Peritoneal dialysis, year of onset

$301,440.53

$16,391.55

[24]f

Peritoneal dialysis, each subsequent year

$212,620.35

$11,561.74

[24]

Kidney transplant costs, first year

$425,899.73

$23,159.31

[25]g

Kidney transplant each subsequent year

$27,466.00

$1493.53

[25]h

 Acute events

Major hypoglycemia

$37,000.53

$2011.99

[25]

Minor hypoglycemia

$990.00

$53.83

[26]i

Ketoacidosis event

$37,000.53

$2011.99

[25]

Lactic acidosis event

$37,000.53

$2011.99

[25]

Edema onset (adverse event)

$990.00

$53.83

[26]i

Edema follow up (adverse event)

$957.00

$52.04

[26]j

 Eye disease

Laser treatment

$24,097.72

$1310.37

[25]

Cataract operation

$35,895.20

$1951.89

[24]

Following cataract operation

$957.00

$52.04

[26]j

Blindness, year of onset

$52,652.36

$2863.10

[25]

Blindness, each subsequent year

$957.00

$52.04

[26]j

 Neuropathy/foot ulceration/amputation

Neuropathy, year of onset

$63,586.97

$3457.69

[25]

Neuropathy, each subsequent year

$37,982.45

$2065.39

[24]

Amputation, year of event

$157,824.66

$8582.09

[25]

Amputation prosthesis (event based)

Not covered

  

Gangrene treatment

$118,143.63

$6424.34

[25]

After healed ulcer

$957.00

$52.04

[26]j

Infected ulcer

$45,010.25

$2447.54

[24]

Standard uninfected ulcer

$32,703.13

$1778.31

[24]

 Medications (per month) and screening (per procedure)

Statins

$50.59

$2.75

[23]k

Aspirin

$0.09

$0.00

[23]

Angiotensin converting enzyme (ACE) inhibitors

$7.30

$0.40

[23]k

Anti-depression treatment

$981.78

$53.39

[23, 26]

Screening for microalbuminuria

$97.00

$5.27

[26]l

Screening for gross proteinuria

$97.00

$5.27

[26]l

Stopping ACE inhibitors due to serious events

$10.38

$0.56

[23]

Screening for retinopathy

$316.00

$17.18

[26]

Screening for depression

$957.00

$52.04

[26]j

  1. DRGs were converted from 2014 to 2016 costs using a health care specific inflation rate of 0.0865, as reported by INEGI. Ψ Costs were estimated as equivalent to 10% of the cost of the acute event where the acute event is estimated as 90% of the total DRG cost, as proposed by Reynales-Shigematsu et al. [27]
  2. aCost of the insulin pump and annual supplies for insertion (Quick Serter) and infusion (Quick Set), reservoirs, lancets, test strips and insulin. Insulin costs were calculated considering (1) average weight of the baseline cohort of 65.45 kg, (2) daily doses 0.1 IU/kg, (3) daily requirement 6.545 IU, (4) annual requirement 2388.925 IU, (5) unit cost of $2.12 per IU of lispro insulin
  3. bCalculated considering (1) insulin types, daily doses obtained from the clinical records of the baseline cohort and (2) unit cost according to the type of insulin
  4. cWeighted cost of AMI of patients with discharge due to improvement (56%) and mortality (44%), weight based on patient distribution of GRDs
  5. dWeighted cost of stroke of patients with (14%) and without (86%) infarction, weight based on patient distribution of GRDs
  6. eHemodialysis procedure plus anastomosis artery-vein required
  7. fWeighted average of manual (54%) and automated (46%) procedures based on MĂ©ndez-Duran [28], plus cost of peritoneal dialysis performed in operating room
  8. gTransplant plus post-transplant short-term care according to the transplant protocol at the Mexican National Institute of Medical Sciences and Nutrition “Salvador Zubiran” (INCMNSZ) [29]
  9. hFollow-up healthcare, according to Mexico´s INCMNSZ transplant protocol
  10. iCost of one visit to the emergency room
  11. jCost of one consultation with specialist
  12. kWeighted average cost of the drugs of the corresponding group of drugs by the percentage of consumption of the same. Example: Weighted average cost = (Cost of Antihypertensive “A”) * (% of patients who uses the antihypertensive “A”) + (Cost of Antihypertensive “B”) * (% of patients taking Antihypertensive “B”)
  13. lCost of laboratory test in a second level medical unit
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Cost Effectiveness and Resource Allocation

ISSN: 1478-7547

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