TY - JOUR
T1 - Conducting cost-effectiveness analyses of type 2 diabetes in low- and middle-income countries
T2 - Can locally generated observational study data overcome methodological limitations?
AU - Baik, Sei Hyun
AU - Chacra, Antônio Roberto
AU - Yuxiu, Li
AU - White, Jeremy
AU - Güler, Serdar
AU - Latif, Zafar A.
N1 - Funding Information:
The authors take full responsibility for this paper but acknowledge editorial assistance from ESP Bioscience, Sand-hurst, UK, which was supported by Novo Nordisk A/S (Bagsværd, Denmark).
PY - 2010/5
Y1 - 2010/5
N2 - In low- and middle-income countries, the high personal and economic burden of type 2 diabetes is further compounded by inadequate resources for diabetes care when compared with high-income countries. Health technology assessments (HTAs) aim to inform policy decision makers in their efforts to achieve more effective allocation of resources by providing evidence-based input on new technologies. Within the hierarchy of evidence, randomized controlled trials (RCTs) remain the 'gold standard' used to inform HTAs, but are limited by poor external validity (ie, generalizability to real-world populations). Unlike RCTs, observational studies are able to enrol broader patient populations, but their design renders such studies vulnerable to confounding factors and selection bias. However, it is increasingly recognized that observational studies can complement RCTs by supporting and extending efficacy findings from RCTs to real-world clinical practice, particularly across geographical populations. They can also provide locally relevant baseline and disease natural history data to populate health economic models. Thus, observational data are likely to be of considerable informative value to policy makers in developing countries reaching decisions on diabetes care within an environment of scarce resources.
AB - In low- and middle-income countries, the high personal and economic burden of type 2 diabetes is further compounded by inadequate resources for diabetes care when compared with high-income countries. Health technology assessments (HTAs) aim to inform policy decision makers in their efforts to achieve more effective allocation of resources by providing evidence-based input on new technologies. Within the hierarchy of evidence, randomized controlled trials (RCTs) remain the 'gold standard' used to inform HTAs, but are limited by poor external validity (ie, generalizability to real-world populations). Unlike RCTs, observational studies are able to enrol broader patient populations, but their design renders such studies vulnerable to confounding factors and selection bias. However, it is increasingly recognized that observational studies can complement RCTs by supporting and extending efficacy findings from RCTs to real-world clinical practice, particularly across geographical populations. They can also provide locally relevant baseline and disease natural history data to populate health economic models. Thus, observational data are likely to be of considerable informative value to policy makers in developing countries reaching decisions on diabetes care within an environment of scarce resources.
KW - Cost-effectiveness analyses
KW - Health economic models
KW - Observational studies
KW - Type 2 diabetes
UR - http://www.scopus.com/inward/record.url?scp=77952733674&partnerID=8YFLogxK
U2 - 10.1016/S0168-8227(10)70004-8
DO - 10.1016/S0168-8227(10)70004-8
M3 - Article
C2 - 20466164
AN - SCOPUS:77952733674
VL - 88
SP - S17-S22
JO - Diabetes Research and Clinical Practice
JF - Diabetes Research and Clinical Practice
SN - 0168-8227
IS - SUPPL. 1
ER -