Cost‐effectiveness of the psycho‐educational blended (group and online) intervention HypoAware compared with usual care for people with Type 1 and insulin‐treated Type 2 diabetes with problematic hypoglycaemia: analyses of a cluster‐randomized controlled trial. Issue 2 (12th December 2017)

• Record Type: Journal Article
• Authors: de Wit, M.; Rondags, S. M. P. A.; van Tulder, M. W.; Snoek, F. J.; Bosmans, J. E.
• Is Part Of: Diabetic medicine. Volume 35:Issue 2(2018)
• Page Start: 214
• Page End: 222
• Publication Date: 2017-12-12
• Subjects: Diabetes -- Periodicals; 616.462
• DOI: 10.1111/dme.13548
• Languages: English
• ISSNs: 0742-3071

Abstract

Abstract: Aims: To evaluate the cost‐effectiveness of HypoAware, a blended (group and online) psycho‐educational intervention based on the evidence‐based Blood Glucose Awareness Training, in comparison with usual care in people with Type 1 and Type 2 diabetes with a high risk of severe hypoglycaemia. Methods: We performed an economic evaluation, from a societal and healthcare perspective, that used data from a 6‐month, multicentre, cluster‐randomized controlled trial ( n = 137). Results: The proportion of people with at least one severe hypoglycaemic event per 6 months was 0.22 lower (95% CI –0.39 to –0.06) and the proportion of people with impaired hypoglycaemia awareness was 0.16 lower (95% CI –0.34 to 0.02) in the HypoAware group. There was no difference in quality‐adjusted life‐years (–0.0; 95% CI –0.05 to 0.05). The mean total societal costs in the HypoAware group were EUR708 higher than in the usual care group (95% CI –951 to 2298). The mean incremental cost per severe hypoglycaemic event prevented was EUR2, 233. At a willingness‐to‐pay threshold of EUR20, 000 per event prevented, the probability that HypoAware was cost‐effective in comparison with usual care was 54% from a societal perspective and 55% from a healthcare perspective. For quality‐adjusted life‐years the incremental cost‐effectiveness ratio was EUR119, 360/quality‐adjusted life‐year gained and the probability of cost‐effectiveness was low at all ceiling ratios. Conclusions: Based on the present study, we conclude that HypoAware is not cost‐effective compared to usual care. Further research in less well‐resourced settings and more severely affected patients is warranted. (Clinical Trials Registry no: Dutch Trial Register NTR4538.) What's new?: We have evaluated the cost‐effectiveness of HypoAware, a blended (group and online) psycho‐educational intervention based on the evidence‐based Blood Glucose Awareness Training, in comparison with usual care in people with diabetes with a high risk of severe hypoglycaemia. HypoAware was not cost‐effective from a societal perspective in comparison with usual care. Further research in less well‐resourced settings and more severely affected patients is warranted.