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In the UK, almost 5 million people live with diabetes. Health Economic diabetes computer simulation modelling is now integral in the evaluation of diabetes therapies and technologies to determine whether they are cost-effective. Prof Clarke has had over 20 years’ experience in diabetes simulation modelling having developed the UK Prospective Diabetes Study Outcomes Model (UKPDS-OM) at the University of Oxford.  This model is the foundation of most type 2 diabetes simulation models worldwide and has been used by pharmaceutical industry, policy makers and researchers to inform decisions about the value of new technologies and make projections of the impact of diabetes and related health policies. A software implementation of the model has been issued commercially to several companies and been used by National Institute for Health and Care Excellence (NICE) in 2015 and 2021 to set pharmaceutical guidelines for diabetes care. This project is a collaboration between the University of Oxford and the Health Economics & Outcomes Research (HEOR).


The aim of this project is to:

  • update and enhance aspects of the UKPDS-OM making the best use of evidence from large contemporary datasets;
  • improve our understanding of the progression of diabetes and its complications while capturing the treatment effects of newer classes of drugs.

To achieve these aims, we will use patient level data from up to six large long-term randomised controlled trials and registries, which have the long-term follow-up data on people with diabetes that can be used for simulation model development. HEOR will provide access to data from recent large trials (e.g. DAPA-CKD, DAPA-HF, DECLARE-TIMI 58 trial) and complement data already held by Oxford (e.g. CPRD, UK Biobank, UKPDS, EXSCEL, TECOS, ADVANCE). Access to such data will facilitate updating of the UKPDS-OM and respective simulation modelling software as there have been significant changes in the progression of diabetes since the end of the UKPDS in 2007 including reductions in rates of mortality and complications.

Furthermore, the existing UKPDS-OM and other diabetes models cannot capture the effects of several new therapies for diabetes, such as Sodium–glucose cotransporter-2 inhibitors (SGLT2i) which have demonstrated reductions in cardiovascular and renal complications that are not captured using risk factors such as HbA1c. The collaboration with HEOR will ensure that that we use the best methods to capture the benefits of the new therapies for diabetes that are relevant to the different stakeholders (model users, industry and policy makers). This will be achieved by developing a next generation model capable of making use of all relevant data.