A Healthcare Economic Policy for Non-Insulin-Dependent Diabetes Mellitus Type 2 Patients Monitoring in Ukraine

Doctoral Thesis / Dissertation from the year 2021 in the subject Economy - Health Economics, grade: N/A, , language: English, abstract: This research explores the cost, life expectancy and quality of life impact of a national quarterly monitoring program on type 2 diabetes for non-insulin-dependent patients. In Ukraine, many people suffer from diabetes and its complications. In this research we focus only on type 2 diabetes, as the most common type of diabetes. Among those we focus only on non-insulin-dependent patients, as these are the patients that would benefit the most from the improved monitoring. Diabetes leads to lower life expectancy, lower quality of life of an individual, and higher healthcare costs both for people and the healthcare system. This burden increases even more if diabetes is not managed. The research analyses the potential impact of a nationwide point of care based non-insulin-dependent diabetics monitoring program. The research method used in the study is the combined cost-effectiveness analysis and budget impact analysis from the payer perspective. This is a special type of the summative evaluation research used to assess the impact of a healthcare program. With the research method, the author answers the question whether the proposed diabetes monitoring strategy is more cost-effective than the standard of care. The author also answers the question what the impact of a nation-wide diabetes monitoring program on the annual healthcare budget of the payer would be. He also analyses the average cost associated with diabetes during the lifetime of an average patient from the payer perspective; the impact on the quality of life of such a patient, and on her (his) life expectancy. All this provides important information to assess the impact of an alternative healthcare economic policy for diabetes. Two formal decision scientific models were developed. They model the situation of diabetics with quarterly point of care based HbA1c monitoring program and compare it with the standard of care. The main types of input data for the models are transition probabilities between different health states, cost and utility of each individual health state. The data used in the models were taken from the literature review of publications and discussions with healthcare professionals in Ukraine.