{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:04:49Z","timestamp":1786122289701,"version":"build-2736575974"},"reference-count":37,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To quantify the long\u2010term clinical and complication\u2010related economic burden of therapeutic inertia in type 2 diabetes mellitus (T2DM) in China, focusing on delayed insulin initiation and intensification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A health economic analysis was conducted from the perspective of the Chinese healthcare system using the validated CORE Diabetes Model. Two cohorts were simulated to compare timely versus delayed insulin initiation and intensification. Base\u2010case assumptions included a baseline HbA1c of 9.0%, a 5\u2010year treatment delay and a 30\u2010year time horizon. Model inputs, including patient characteristics, treatment effects, costs and utilities, were sourced from published literature, prioritising Chinese data. Outcomes included quality\u2010adjusted life years (QALYs), complication incidence and complication\u2010related direct medical costs, with scenario analyses performed to test robustness. Results were also extrapolated to the national population of Chinese patients with uncontrolled T2DM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Timely insulin initiation was associated with an average saving of \u00a511\u2009370 per patient and a gain of 0.086 QALYs compared with a 5\u2010year delay. Timely intensification yielded cost savings of \u00a510\u2009417 and an incremental 0.093 QALYs per patient. At the population level, these corresponded to total savings of \u00a568.2 billion and \u00a562.5 billion, and additional 515\u2009604 and 557\u2009572 QALYs, respectively. Scenario analyses confirmed that health and cost benefits increased with higher baseline HbA1c and longer time horizons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Therapeutic inertia in T2DM management imposes quantifiable QALY losses and complication\u2010related cost burdens in China. Timely insulin initiation and intensification significantly improve outcomes and reduce costs, underscoring the urgency of overcoming therapeutic inertia through patient, physician and system\u2010level strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.71011","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T05:08:10Z","timestamp":1782882490000},"page":"8494-8503","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Modelling the Clinical and Complication\u2010Related Economic Burden of Therapeutic Inertia in People With Type 2 Diabetes in China"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-7414-4674","authenticated-orcid":false,"given":"Yingdan","family":"Cao","sequence":"first","affiliation":[{"name":"Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy Xi'an Jiaotong University  Xi'an China"},{"name":"Center for Drug Safety and Policy Research Xi'an Jiaotong University  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinran","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy Xi'an Jiaotong University  Xi'an China"},{"name":"Center for Drug Safety and Policy Research Xi'an Jiaotong University  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaodong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy Xi'an Jiaotong University  Xi'an China"},{"name":"Center for Drug Safety and Policy Research Xi'an Jiaotong University  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengyu","family":"Liu","sequence":"additional","affiliation":[{"name":"Novo Nordisk (China) Pharmaceutical Co. Ltd.  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy Xi'an Jiaotong University  Xi'an China"},{"name":"Center for Drug Safety and Policy Research Xi'an Jiaotong University  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.168118"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.7596"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.22208"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0908292"},{"key":"e_1_2_12_6_1","volume-title":"IDF Diabetes Atlas","author":"International Diabetes Federation","year":"2025"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.19720"},{"issue":"34","key":"e_1_2_12_8_1","first-page":"4377","article-title":"Clinical Inertia in Diabetes Management and Systematic Prevention Methods","volume":"23","author":"Li D.","year":"2020","journal-title":"Chinese General Practice"},{"issue":"2","key":"e_1_2_12_9_1","first-page":"81","article-title":"Clinical Inertia and Its Influencing Factors During the Treatment Process of Patients With Type 2 Diabetes Mellitus: Results From a Multicenter Observational Study","volume":"12","author":"Li X.","year":"2020","journal-title":"Chinese Journal of Diabetes"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m997"},{"issue":"3","key":"e_1_2_12_11_1","first-page":"222","article-title":"Survey and Analysis of Oral Antidiabetic Drug Treatment Patterns in Outpatients With Type 2 Diabetes Mellitus in Large Cities of China","volume":"22","author":"Wang Y.","year":"2018","journal-title":"Chinese Journal of Disease Control & Prevention"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2015.0054"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12937-025-01101-z"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-015-0260-x"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-019-01199-8"},{"issue":"1","key":"e_1_2_12_16_1","first-page":"16","article-title":"Guidelines for the Prevention and Treatment of Diabetes in China (2024 Edition)","volume":"17","author":"Chinese Diabetes Society","year":"2025","journal-title":"Chinese Journal of Diabetes"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc24-SINT"},{"key":"e_1_2_12_18_1","first-page":"29","article-title":"Health Economic Evaluation of Early Treatment for Type 2 Diabetes Mellitus in China","volume":"7","author":"Guan Hj H. W. L. X.","year":"2017","journal-title":"Chinese Journal of Health Economics"},{"issue":"4","key":"e_1_2_12_19_1","first-page":"5","article-title":"Health Economic Evaluation of Early Treatment for Type 2 Diabetes Mellitus in China: An Analysis Based on the UKPDS Model","volume":"39","author":"Ding Nx Q. Y. Z. K.","year":"2018","journal-title":"Medicine and Philosophy (Humanistic & Social Medicine Edition)"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2021.11.1351"},{"key":"e_1_2_12_21_1","first-page":"S27","article-title":"Validation of the CORE Diabetes Model Against Epidemiological and Clinical Studies","volume":"20","author":"Palmer A. J.","year":"2004","journal-title":"Current Medical Research and Opinion"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2014.07.007"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13300-021-01166-z"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-008-0080-4"},{"issue":"1","key":"e_1_2_12_25_1","first-page":"173","article-title":"Evaluating the Long\u2010Term Cost\u2010Effectiveness of Fixed\u2010Ratio Combination Insulin Degludec\/Liraglutide (IDegLira) Versus Other Treatment Regimens in the Chinese Type 2 Diabetes Patients","volume":"15","author":"Wei R.","year":"2023","journal-title":"Diabetes, Metabolic Syndrome and Obesity"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13300-019-00683-2"},{"key":"e_1_2_12_27_1","volume-title":"Guidelines for Pharmacoeconomic Evaluations 2020 (Chinese\u2010English Version)","author":"Liu G. E.","year":"2020"},{"key":"e_1_2_12_28_1","unstructured":"E. A.Leili Gao \u201cAssessing Current Glycemic Control in Newly Diagnosed Diabetes Patients in China \u201dPresented at: American Diabetes Association 75th Scientific Sessions Boston MA USA (2015)."},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1326.2012.01602.x"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc13-0331"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00400195"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.280.20.1757"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.022367"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.16139"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1080\/13696998.2019.1645018"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-024-02978-8"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.14376"},{"key":"e_1_2_12_38_1","first-page":"2024","volume-title":"Saudi Diabetes Clinical Practice Guidelines (SDCPG)","author":"Saudi National Diabetes Center","year":"2021"}],"container-title":["Diabetes, Obesity and Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dom-pubs.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dom.71011","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/dom-pubs.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/dom.71011","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/dom-pubs.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dom.71011","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T08:50:19Z","timestamp":1786092619000},"score":1,"resource":{"primary":{"URL":"https:\/\/dom-pubs.onlinelibrary.wiley.com\/doi\/10.1111\/dom.71011"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,30]]},"references-count":37,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/dom.71011"],"URL":"https:\/\/doi.org\/10.1111\/dom.71011","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.1111\/DOM.71011\/v1\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.71011\/v2\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.71011\/v2\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.71011\/v1\/review3","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.71011\/v1\/review4","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.71011\/v1\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.71011\/v1\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.71011\/v2\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.71011\/v2\/review1","asserted-by":"object"}]},"ISSN":["1462-8902","1463-1326"],"issn-type":[{"value":"1462-8902","type":"print"},{"value":"1463-1326","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,30]]},"assertion":[{"value":"2026-04-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}