Controlling glucose, blood pressure (BP), and lipid is essential for reducing risks of diabetes-related complications, but the costs associated with achieving different target levels are not well documented. We assessed the costs of delivering intensive or standard glucose, BP and lipid control strategies in ACCORD study, a randomized, multicenter, double 2 x 2 factorial design study to compare cardiovascular disease (CVD) outcomes in 10,251 high CVD risk participants with type 2 diabetes. We estimated the intervention costs associated with each study arm by year for each participant. First, we grouped the costs into four major categories: personnel, medication, devices and supplies, and laboratory tests. Second, we estimated the frequency of utilization by category using data from either patient electric records or surveys. Third, we determined the unit cost for the corresponding cost category. Fourth, the annual cost by category was estimated as the product of utilization frequency and the unit cost. Finally the total intervention cost was the sum of the four cost categories. The estimated average costs per participant by intervention mode and year are presented in table. Although these data are from a trial, the estimates may be useful to predict the pattern of resources needed for achieving different targeted levels of glucose, BP, or lipid control.
Year Standard glucose (in 2008 $)
Standard BP Intensive BP Standard lipid Intensive lipid Standard BP Intensive BP Standard Lipid Intensive lipid
Year 1 6,899 8,339 7,347 8,037 8,893 9,620 8,513 9,831
Year 2 8,133 9,181 8,647 9,068 9,714 11,093 10,191 11,599
Year 3 9,446 10,361 9,197 9,962 11,478 12,621 11,972 13,111
Year 4 9,546 10,009 9,678 10,996 11,245 12,048 12,114 12,622
Total 34,024 37,890 34,869 38,063 41,330 45,382 42,790 47,163