Modeling the Clinical and Economic Burden of Therapeutic Inertia in People with Type 2 Diabetes in Saudi Arabia.
Mohammed Alluhidan, Abdulrahman Alturaiki, Hana Alabdulkarim, Nasser Aljehani, Essam A Alghamdi, Fahad Alsabaan, Abdullah A Alamri, Samuel J P Malkin, Barnaby Hunt, Abdulaziz Alhossan, Ahmed Al-Jedai
Author Information
Mohammed Alluhidan: Health Economics Unit, Saudi Health Council, Riyadh, Saudi Arabia. mluhidan@gmail.com. ORCID
Abdulrahman Alturaiki: Pharmaceutical Care Department, King Abdul Aziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.
Hana Alabdulkarim: Drug Policy and Economic Centre, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.
Nasser Aljehani: Insurance Authority, Riyadh, Saudi Arabia.
Essam A Alghamdi: Security Forces Hospital, Dammam, Saudi Arabia.
Fahad Alsabaan: Division of Endocrinology, Security Forces Hospital, Riyadh, Saudi Arabia.
Abdullah A Alamri: Endocrinology Department, Alhada Armed Forces Hospital, Taif, Saudi Arabia.
Samuel J P Malkin: Ossian Health Economics and Communications, Basel, Switzerland.
Barnaby Hunt: Ossian Health Economics and Communications, Basel, Switzerland.
Abdulaziz Alhossan: College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.
Ahmed Al-Jedai: College of Pharmacy, Alfaisal University, Riyadh, Saudi Arabia.
INTRODUCTION: Therapeutic inertia in type 2 diabetes, defined as a failure to intensify treatment despite poor glycemic control, can arise due to a variety of factors, despite evidence linking improved glycemic control with reductions in diabetes-related complications. The present study aimed to evaluate the health and economic burden of therapeutic inertia in People with type 2 diabetes in Saudi Arabia. METHODS: The IQVIA Core diabetes Model (v.9.0) was used to evaluate outcomes. Baseline cohort characteristics were sourced from Saudi-specific data, with baseline glycated hemoglobin (HbA1c) tested at 8.0%, 9.0%, and 10.0%. Modeled subjects were brought to an HbA1c target of 7.0% immediately or after delays of 1-5 years across time horizons of 3-50 years. Outcomes were discounted annually at 3.0%. Costs were accounted from a societal perspective and expressed in 2023 Saudi Arabian Riyals (SAR). RESULTS: Immediate glycemic control was associated with improved or equal life expectancy and quality-adjusted life expectancy and cost savings in all scenarios compared with delays in achieving target HbA1c. Combined cost savings ranged from SAR 411 (EUR 102) per person with a baseline HbA1c of 8.0% versus a 1-year delay over a 3-year time horizon, to SAR 21,422 (EUR 5291) per person with a baseline HbA1c of 10.0% versus a 5-year delay over a 50-year time horizon. Discounted life expectancy and quality-adjusted life expectancy were projected to improve by up to 0.4 years and 0.5 quality-adjusted life years (QALYs), respectively, with immediate glycemic control. CONCLUSION: Therapeutic inertia was associated with a substantial health and economic burden in Saudi Arabia. Interventions and initiatives that can help to reduce therapeutic inertia are likely to improve health outcomes and reduce healthcare expenditure.
