The Cost-Effectiveness of Lifestyle Interventions for Preventing Diabetes in a Health Resource-Limited Setting

Ma, Jing; Wang, Xu; Wu, Bin

doi:10.1155/2020/7410797

Cited by 11 publications

(7 citation statements)

References 38 publications

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“…Sensitivity analyses were performed on all variables associated with disease prevalence, screening effectiveness, transition probability between states, costs, and discount rate. When there was no available data range, 75–125% of the initial parameters were taken as the variation range of the parameters for sensitivity analysis ( 43 ). Furthermore, the screening compliance rate is essential, and we assume it is 100% in the base model.…”

Section: Methodsmentioning

confidence: 99%

Cost-effectiveness of two screening strategies based on Chinese diabetes risk score for pre-diabetes in China

Hao

Yao

Lin

et al. 2022

Front. Public Health

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ObjectiveStudies have shown that screening for pre-diabetes mellitus (pre-DM) is essential to prevent type 2 diabetes mellitus (T2DM). This study evaluates the cost-effectiveness of two screening strategies that apply the Chinese Diabetes Risk Score (CDRS) to screen for pre-DM in China.MethodsA Markov microsimulation model was conducted from a social perspective, and the input parameters were obtained from published literature or publicly available data. Two screening strategies for pre-DM based on CDRS were built and compared with the control group to determine the cost-effective strategy. The screening strategy of the control group was screening for pre-DM by fasting plasma glucose (FPG) test in adults undergoing annual health examination and no screening in adults without an annual health examination (status quo). Two screening strategies were strategy 1: screening for pre-DM using CDRS in all adults (including with or without an annual health examination); and strategy 2: supplemental self-screening for pre-DM using CDRS in adults without an annual health examination, based on the status quo. We focus on the cumulative prevalence of T2DM and the incremental cost-effectiveness ratio which signifies the cost per case of T2DM prevented. We also evaluated the cost-effectiveness from the health system perspective. One-way and probabilistic sensitivity analyses were conducted to verify the robustness of the results.ResultsThe costs a case of T2DM prevented for strategy 1 compared with the control group and strategy 2 were $299.67 (95% CI 298.88, 300.46) and $385.89 (95% CI 381.58, 390.20), respectively. In addition, compared with the control group, the cost of strategy 2 to prevent a case of T2DM was $272.23 (95% CI 271.50, 272.96).ConclusionsScreening for pre-DM using CDRS in all adults was the most cost-effective health policy. We suggest that medical institutions replace FPG with CDRS for pre-DM screening; at the same time, self-screening for pre-DM using CDRS is widely promoted among adults without an annual health examination. There were still some disputes about how CDRS is included in the health examination projects, so strategy 2 should be considered as an alternative screening strategy. Findings provide a reference for the application of the CDRS in pre-DM screening and contribute to T2DM prevention.

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Section: Methodsmentioning

confidence: 99%

Cost-effectiveness of two screening strategies based on Chinese diabetes risk score for pre-diabetes in China

Hao

Yao

Lin

et al. 2022

Front. Public Health

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“…We conducted one-way and probabilistic sensitivity analyses to explore the effect of parameter uncertainty [30][31][32]. In the one-way sensitivity analyses, we used the minimum and maximum estimates for all key parameters, testing the in uence of extreme variations in each parameter on the overall results.…”

Section: Sensitivity Analysesmentioning

confidence: 99%

Cost-effectiveness analysis of multiple gastric cancer screening strategies in Northwest China based on a population program: a Markov modeling study

Liu

Zheng

Zhou

et al. 2022

Preprint

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Background Gastric cancer remains a significant global health problem and poses heavy public health and economic burdens on the health system. This study aimed to compare cost-effectiveness among multiple gastric cancer screening strategies and identify the most cost-effective one in Northwest China based on a population-based cohort study using a Markov model. Methods Based on the real-world data, a Markov model was developed to evaluate the cost-effectiveness of 21 screening strategies with various screening methods, starting ages, stopping ages, and screening intervals versus no screening for a high-risk gastric cancer population in China. The primary outcomes were quality-adjusted life-years (QALY), costs, effectiveness, and the incremental cost-effectiveness ratio (ICER). One-way and probabilistic sensitivity analyses explored uncertainty. Results Our baseline model of annual endoscopic screening for individuals aged 40 to 75 years was the cost-effective strategy, with an ICER of US$ 545.79/QALY compared with no screening. In the scenario analysis, only the H. pylori screen-and-treat from 20 years strategy was non-dominated, with an ICER of US$ 157.41/QALY, and all other systems were dominated (providing less benefit but higher cost). Using the US$ 15,000 per QALY, all selected screening strategies for gastric cancer were cost-effective in the high-risk region of Northwest China. One-way and probabilistic sensitivity analyses demonstrated that the results are robust. Conclusions This modelling study provides evidence for the cost-effectiveness of an endoscopic screening program for gastric cancer in the high-risk region of China. Primary prevention appears more cost-effective than secondary prevention strategies. If primary prevention is not an option, secondary prevention strategies should be considered. All selected screening strategies seem to be cost-effective in the high-incidence area of Northwest China.

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“…Several reviews conducted in high-income countries reported that health behavior interventions, including those focusing on diet and physical activity, are cost-effective for the management and treatment of T2DM [ 22 , 23 , 24 ]. Health behavior interventions also reduce the probability of developing T2DM by 9.53% and have additional positive outcomes on life expectancy, quality-adjusted life year (QALY), and total cost savings over a lifetime [ 25 , 26 , 27 , 28 ].…”

Section: Introductionmentioning

confidence: 99%

Economic Evaluation of Health Behavior Interventions to Prevent and Manage Type 2 Diabetes Mellitus in Asia: A Systematic Review of Randomized Controlled Trials

Dahal

Rawal

Mahumud

et al. 2022

IJERPH

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Health behavior interventions implemented in Asian countries often lack economic evaluations that effectively address the problems of type 2 diabetes mellitus. This review systematically assessed the existing literature on economic evaluation of health behavior interventions to prevent and manage type 2 diabetes mellitus for people living in Asian countries. Eligible studies were identified through a search of six bibliographic databases, namely, PubMed, Scopus, Public Health Database by ProQuest, Cumulative Index to Nursing and Allied Health Literature Complete, Web of Science, and Google Scholar. Randomized controlled trials of health behavior interventions and studies published in the English language from January 2000 to May 2022 were included in the review. The search yielded 3867 records, of which 11 studies were included in the review. All included studies concluded that health behavior interventions were cost-effective. Eight of these studies undertook an evaluation from a health system perspective, two studies used both societal and health system perspectives, and one study utilized a societal and multi-payer perspective. This review identified the time horizon, direct and indirect medical costs, and discount rates as the most important considerations in determining cost effectiveness. These findings have implications in extending health behavior interventions to prevent and manage type 2 diabetes mellitus in low-resource settings, and are likely to yield the most promising outcomes for people with type 2 diabetes mellitus.

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The Cost-Effectiveness of Lifestyle Interventions for Preventing Diabetes in a Health Resource-Limited Setting

Cited by 11 publications

References 38 publications

Cost-effectiveness of two screening strategies based on Chinese diabetes risk score for pre-diabetes in China

Cost-effectiveness of two screening strategies based on Chinese diabetes risk score for pre-diabetes in China

Cost-effectiveness analysis of multiple gastric cancer screening strategies in Northwest China based on a population program: a Markov modeling study

Economic Evaluation of Health Behavior Interventions to Prevent and Manage Type 2 Diabetes Mellitus in Asia: A Systematic Review of Randomized Controlled Trials

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