While we found relatively good st and ards of reporting the study ’s question , population , interventions , comparators and conclusions , the overall reporting was poor , and evidence of unfamiliarity with international guidelines was evident ( i.e. absence of incremental analysis , of discounting long-term costs and effects ) .
Analysis or description of place-to-place variability was infrequent .
Use and acceptance of health economic evaluations ( HEEs ) has been much greater in developed than in developing nations .
Nevertheless , while developing countries lag behind in the development of HEE methods , they could benefit from the progress made in other countries and concentrate on ways in which existing methods can be used or would need to be modified to fulfill their specific needs .
HEEs , as context -specific tools , are not easily generalizable from setting to setting .
Existing studies regarding generalizability and transferability of HEEs have primarily been conducted in developed countries .
Therefore , a legitimate question for policy makers in Latin America and the Caribbean region ( LAC ) is to what extent HEEs conducted in industrialized economies and in LAC are generalizable to LAC ( trans-regional ) and to other LAC countries ( intra-regional ) , respectively .
A model educational program for people with type 2 diabetes: a cooperative Latin American implementation study (PEDNID-LA).
OBJECTIVE To implement an educational program in 10 Latin American countries and to evaluate its effect on the clinical , biochemical , and therapeutic aspects as well as the economic cost of diabetes . RESEARCH DESIGN AND METHODS Educators from each participating country were previously trained to implement the educational model .  The patient population included 446 individuals with type 2 diabetes ; all patients were < 65 years of age , did not require insulin for metabolic control , did not have severe complications of diabetes or life-limiting illnesses , and had not previously participated in diabetes education courses .  Clinical and therapeutic data and the cost of their pharmacological treatment were collected 6 months before participation in the educational program ( -6 months ) , on entry into the program ( time 0 ) , and at 4 , 8 , and 12 months after initiation of the program . RESULTS All parameters measured had improved significantly ( P < 0.001 ) by 1 year : fasting blood glucose ( mean + /- SD ) 10.6 + /- 3.5 vs. 8.7 + /- 3.0 mmol/l ; HbA(1c ) 9.0 + /- 2.0 vs. 7.8 + /- 1.6 % ; body weight 84.6 + /- 14.7 vs. 81.2 + /- 15.2 kg ; systolic blood pressure 149.6 + /- 33.6 vs. 142.9 + /- 18.8 mmHg ; total cholesterol 6.1 + /- 1.1 vs. 5.4 + /- 1.0 mmol/l ; and triglycerides 2.7 + /- 1.8 vs. 2.1 + /- 1.2 mmol/l . At 12 months , the decrease in pharmacotherapy required for control of diabetes , hypertension , and hyperlipidemia represented a 62 % decrease in the annual cost of treatment ( $ 107,939.99 vs. $ 41,106.30 [ U.S. ] ) . After deducting the additional cost of glucosuria monitoring ( $ 30,604 ) , there was still a 34 % annual savings . CONCLUSIONS The beneficial results of this educational model , implemented in 10 Latin American countries , reinforce the value of patient education as an essential part of diabetes care . They also suggest that an educational approach promoting healthy lifestyle habits and patient empowerment is an effective strategy with the potential to decrease the development of complications related to diabetes as well as the socioeconomic costs of the disease
While we found relatively good st and ards of reporting the study ’s question , population , interventions , comparators and conclusions , the overall reporting was poor , and evidence of unfamiliarity with international guidelines was evident ( i.e. absence of incremental analysis , of discounting long-term costs and effects ) .
Analysis or description of place-to-place variability was infrequent .
Use and acceptance of health economic evaluations ( HEEs ) has been much greater in developed than in developing nations .
Nevertheless , while developing countries lag behind in the development of HEE methods , they could benefit from the progress made in other countries and concentrate on ways in which existing methods can be used or would need to be modified to fulfill their specific needs .
HEEs , as context -specific tools , are not easily generalizable from setting to setting .
Existing studies regarding generalizability and transferability of HEEs have primarily been conducted in developed countries .
Therefore , a legitimate question for policy makers in Latin America and the Caribbean region ( LAC ) is to what extent HEEs conducted in industrialized economies and in LAC are generalizable to LAC ( trans-regional ) and to other LAC countries ( intra-regional ) , respectively .