Cost-Effectiveness Analysis of Fenofibrate for the Prevention of Diabetes Complications in People Suffering From Type 2 Diabetes Mellitus

OBJECTIVES: The financial burden of type 2 diabetes mellitus (T2DM) is estimated to surpass AUD10 billion mainly due to the cost of diabetic complications from diabetic neuropathy. The Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study has previously reported that fenofibrate significantly reduces diabetic complications.

METHODS: An Australian diabetes cohort was simulated using data from the Australian National Diabetes Audit Annual Report (2022). The UKPDS outcomes model 2 was used to simulate patient-level diabetes outcomes over a 20-year time horizon. The risk of diabetic complications was taken the FIELD study. A cost-effectiveness model was constructed to evaluate the cost and quality adjusted life years over the time horizon. Cost and quality of life inputs were sourced from government websites and the literature. Incremental cost effectiveness ratios were calculated and a standard discount rate of 3% was applied.

RESULTS: The model predicted fewer amputations, blindness, heart failure, ischemic heart disease, myocardial infarction, renal failure and strokes for people treated with FEN vs noFEN. The additional cost of treating 1000 patients with FEN was AUD 0.41M compared to noFEN. The incremental cost-effectiveness ratio is AUD0.41M/548=AUD739/LY gained and AUD0.41M/341=AUD1,189/QALY gained.

CONCLUSIONS: Fenofibrate is a cost-effective way of preventing diabetic complications in an Australian T2DM population.