Evidence map›Paper›PMID 40607724›Full record

Trial reportDiabetic medicine : a journal of the British Diabetic Association2025

Cost-effectiveness of fenofibrate versus standard care for reducing the progression of diabetic retinopathy: An economic evaluation based on data from the LENS trial.

Graham Scotland, Mekazin Tsehaye, Caroline Styles, Jennifer Logue, Emily Sammons, Mohammed Zayed, Jonathan Emberson, Rachel Wade, Karl Wallendszus, Will Stevens and 7 more

Abstract readRandomized Controlled TrialComparative Study
In one paragraph

Trial report in Diabetic medicine : a journal of the British Diabetic Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Graham ScotlandHealth Economics Research Unit, University of Aberdeen, Aberdeen, UK.ORCID https://orcid.org/0000-0001-5539-8819
Mekazin TsehayeHealth Economics Research Unit, University of Aberdeen, Aberdeen, UK.
Caroline StylesQueen Margaret Hospital, Fife, UK.
Jennifer LogueFaculty of Health and Medicine, University of Lancaster, Lancaster, UK.
Emily SammonsClinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Mohammed ZayedClinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.ORCID https://orcid.org/0000-0001-9816-983X
Jonathan EmbersonClinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Rachel WadeClinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Karl WallendszusClinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Will StevensClinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Rosanna CretneyClinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Simon HardingDepartment of eye and Vision Science, University of Liverpool and St. Paul's Eye Unit, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK.
Graham LeeseMolecular and Clinical Medicine, University of Dundee, Dundee, UK.
Gemma CurrieSchool of Cardiovascular & Metabolic Health, University of Glasgow, Glasgow, UK.
Jane ArmitageClinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
David PreissClinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.ORCID https://orcid.org/0000-0003-3139-1836
LENS Collaborative Group

Funding

British Heart FoundationChief Scientist Office, Scottish Government Health and Social Care DirectorateDepartment of Health 14/49/84Health Data Research UKMedical Research CouncilNational Institute for Health and Care ResearchNuffield Department of Population Health
6 · The paper itself

Abstract

aimsThe LENS trial demonstrated that fenofibrate slowed the progression of diabetic retinopathy compared to placebo in participants with early diabetic eye disease. We assessed its cost-effectiveness for reducing the progression of diabetic retinopathy versus standard care from a UK National Health Service perspective.

methodsResource use and outcome data were collected over follow-up for participants enrolled in LENS. Mean costs were compared at 2 years and per 6-month follow-up (median 4.0 years). Within the trial, cost-effectiveness was assessed in terms of the incremental cost per case of referable disease averted. A microsimulation model, with inputs derived primarily from LENS trial data, was used to assess the incremental cost per quality-adjusted life year (QALY).

resultsFenofibrate resulted in a mean (95% confidence interval) reduction in health service costs of -£254 (-1062 to 624) at 2 years and -£101 (-243 to 42) per 6-month follow-up. This was accompanied by a 4.4% (1.3% to 8.0%) absolute reduction in any referable diabetic retinopathy or treatment thereof at 2 years, and a 27% (9%-42%) relative reduction over follow-up. Modelled over 10 years, fenofibrate use cost an additional £6 per patient for an expected QALY gain of 0.02, costing £406 per QALY versus standard care under base case assumptions. The probability of cost-effectiveness varied from 70% to 79% at a threshold of £20,000 per QALY, depending on the price discount applied to anti-VEGF drugs.

conclusionsFenofibrate is likely to offer a cost-effective treatment for slowing the progression of diabetic retinopathy in people with early to moderate diabetic retinopathy or maculopathy.

Indexed as

Diabetes Mellitus, Type 2Diabetic RetinopathyFenofibrateHypolipidemic AgentsCost-Benefit AnalysisDisease ProgressionFemaleFollow-Up StudiesHumansMaleMiddle AgedQuality-Adjusted Life YearsUnited KingdomFenofibrateHypolipidemic Agentscost‐effectiveness analysisdiabetic retinopathyfenofibrate

Identifiers

PMID40607724
PMCPMC7617897

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.