Endocrine Abstracts

Background: The aim of this study was to assess health-related quality of life (HRQoL) of patients living in cities and towns with different population in the Russian Federation (RF) using EQ-5D questionnaire, to calculate health utility index (QALY) and cost-utility ratio (CUR).

Methods: One of the goals of the multicenter, observational, epidemiologic study FORSIGHT-DM2 was to evaluate HRQoL using the EQ-5D Questionnaire. The study included more than 2000 patients with T2DM from 45 cities in the RF. We analysed the impact of different factors associated with the disease itself, specific features of its course, living conditions on the QoL. We performed a multivariable linear regression analysis to estimate the contribution of each independent variable to overall outcome.

Results: The proportion of patients with moderate or severe decrease in HRQoL status with respect to any parameter(s) was significantly higher among patients residing in small cities/towns with population less than 1 million inhabitants compared to patients residing in large cities (over 1 million inhabitants), including Moscow and Saint Petersburg (P<0,001). However, the self-reported health status was comparable in all groups. The assessment of HRQoL using a visual analogue scale (VAS) showed that mean score reflecting self-reported health status of patients with T2DM was 4.97 on a 10-point scale, s=2.4, (49.7 for on a 100-point VAS), after converting this measure of health status into QALY-weights the value was 0.503. The cost of one quality-adjusted life year (CUR) of T2DM patient in RF in 2014 was 209 417 rubles ($3722.4). It was estimated according to the QALY index calculations made in the FORSIGHT-DM2 study using the following equation: CUR=COI / QALY, COI being the total direct medical costs of treating DM2 and its complications and comorbidities amounting 105 337 rubles per patient ($ 2742). Diabetic foot syndrome, depression, diabetic osteoarthropathy, myocardial infarction in anamnesis, and age had the biggest negative impact on HRQoL. Our prognoses showed moderate correlations.

Conclusion: Patients with T2DM have lower HRQoL (49,7) compared to the general population of the Russian Federation in similar age groups (60,1 according to the ESSE-RF study). Health utility index and cost-utility ratio calculated within the study can be used as a criterion for the assessment of medical care quality for patients with T2DM in the RF.

Keywords: type 2 diabetes mellitus, pharmacoepidemiological study, European Quality of Life 5-Dimension Questionnaire (EQ-5D), health utility index, cost-utility ratio.