Cost-effectiveness analysis of home haemodialysis for diabetes mellitus population in Taiwan

Abstract

A191 required to recoup the intervention cost sooner. In this study, we focused on persons at high risks for both hypertension and diabetes and assessed the costeffectiveness of lifestyle interventions from a health plan perspective. METHODS: We used a Markov-based discrete event model to simulate the health and economic outcomes associated with lifestyle interventions compared with normal care over persons' lifetime. The target population is U.S. adults with both prehypertension (a systolic blood pressure of 120-139 mm Hg or diastolic blood pressure of 80-89 mm Hg) and prediabetes. Data on the effect and costs of the intervention were obtained from published clinical trials. Outcomes included the incidences of diabetes and cardiovascular diseases, quality adjusted life years (QALY), and cost per QALY. Costs were expressed in 2012 US dollar. RESULTS: In persons aged 18-64, the intervention reduced the incidence of diabetes by 22% and major cardiovascular diseases by 7% over a lifetime. In persons aged 65-84, the corresponding reductions were 32% and 3% respectively. The intervention would save $3,500 and $1,500 per person among those aged 18-64 and 65-84 respectively. The intervention achieved cost-even in 10 years among those aged 18-64 and in 6 years among those aged 65-84 since initiation. CONCLUSIONS: Lifestyle intervention, targeting to persons at a high risk for both hypertension and diabetes, would lead to a greater lifetime saving and sooner recovery of the intervention costs, compared with targeting to those at risk for diabetes alone.