Implementing intensive control of blood glucose concentration and blood pressure in type 2 diabetes in England: cost analysis (UKPDS 63)

Objective To estimate the incremental cost of implementing policies for more intensive control of blood glucose concentration and blood pressure for all patients with type 2 diabetes in England. Design Extrapolation of resource use and cost data derived from a randomised controlled trial. Setting General practice, outpatient care, and inpatient care. Population Trial population with diagnosed type 2 diabetes in England extrapolated to the population of England. Main outcome measures Total costs based on use of healthcare resources including costs of management, treatment, and hospitalisation. Results The incremental net annual cost of implementing more intensive control of blood glucose and blood pressure to all people with diagnosed type 2 diabetes in England is estimated to be pound100.5m ($156m; is not an element of159m), which is equivalent to less than 1% of the proposed additional annual expenditure on the NHS in 2001-5. This estimate varied in sensitivity analyses from pound67m to pound121m. Conclusions Policies to improve control of blood glucose and blood pressure of people with type 2 diabetes are effective in reducing complications associated with the disease and are also cost effective. The total cost represents a small fraction of the NHS's spending plans.