The Cost-Effectiveness of Treating All Patients with Type 2 Diabetes with Angiotensin-Converting Enzyme Inhibitors

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   Figure 1. ESRD = end-stage renal disease. Health states and clinical strategies in the Markov model.
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   Figure 2. For comparison, the expected outcome for patients who do not receive angiotensin-converting enzyme inhibitors is also shown. Distribution of health states after 10 years for each of the three strategies.
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   Figure 3. In the base case, the annual cost of ACE inhibitor therapy is $320 and the relative risk for progression to microalbuminuria is 0.32. QALY = quality-adjusted life-year. Cost-effectiveness of the “treat all” strategy relative to the “screen for microalbuminuria” strategy as a function of cost of angiotensin-converting enzyme (ACE) inhibitors (top) or relative risk for progression to microalbuminuria (bottom) and age at diagnosis.

• Copyright ©2004 by the American College of Physicians