IQVIA CORE Diabetes Model
The IQVIA -CORE-Diabetes-Model (formerly IMS-CORE Diabetes model) is a no-product specific, diabetes policy analysis tool that performs real time simulations. Disease progression is based on a series of inter-dependent Markov sub-models that simulate diabetes-related complications (angina, MI, congestive heart failure, stroke, peripheral vascular disease, diabetic retinopathy, macular edema, cataract, hypoglycaemia, ketoacidosis, nephropathy and end stage renal disease, neuropathy, foot ulcer and amputation). Each sub-model uses time-, state- and diabetes-type dependent probabilities derived from published sources, and utilizes tracker variables to overcome the memory-less properties of standard Markov models. The progression of relevant physiological parameters (e.g. HbA1c, SBP, lipids, BMI, etc.) is simulated based on long-term epidemiological data and event risk is constantly updated based on the risk factors. Analyses, including first and second order Monte Carlo simulations can be performed on patient cohorts with either type 1 or type 2 diabetes, defined in terms of age, gender, baseline risk factors, pre-existing complications and comorbidities. The model is adaptable, allowing the inclusion of new clinical and economic data s it becomes available. The creation of country-, health maintenance organization- or provider specific versions of the model is possible. Noteworthy, recent updates to the model include a detailed hypoglycaemia sub-module, the inclusion of alternative sets of contemporary risk equations including equations from the UKPDS82, the Swedish-National-Diabetes-Register, the ADVANCE-risk-engine, the Fremantle-study and others. Moreover the type-1-section of the model was entirely revisited to incorporate most recent epidemiological evidence. The reliability of simulated clinical outcomes has been tested with results validated against those reported from contemporary clinical trials and epidemiological studies.
Palmer AJ, Roze S, Valentine WJ, Minshall ME, Foos V, Lurati FM, Lammert M, Spinas GA. Validation of the CORE Diabetes Model against epidemiological and clinical studies. Curr Med Res Opin. 2004 Aug;20 Suppl 1:S27-40.
Palmer AJ, Roze S, Valentine WJ, Minshall ME, Foos V, Lurati FM, Lammert M, Spinas GA. The CORE Diabetes Model: Projecting long-term clinical outcomes, costs and cost-effectiveness of interventions in diabetes mellitus (types 1 and 2) to support clinical and reimbursement decision-making Curr Med Res Opin. 2004 20 Suppl 1:S5-26.
Davies MJ, Chubb BD, Smith IC, Valentine WJ. Cost-utility analysis of liraglutide compared with sulphonylurea or sitagliptin, all as add-on to metformin monotherapy in Type 2 diabetes mellitus. Diabet Med. 2012 Mar;29(3):313-20.
McEwan P, Foos V, Palmer JL, Lamotte M, Lloyd A, Grant D. Validation of the IMS CORE Diabetes Model Value Health. 2014 Sep; 17(6):714-24.
The values below are simulated Quality Adjusted life Years (QALYs) for a set of reference simulations