Cost–utility analysis of lifestyle interventions to prevent type 2 diabetes in women with prior gestational diabetes. (30th October 2019)

• Record Type: Journal Article
• Authors: Werbrouck, Amber; Schmidt, Masja; Putman, Koen; Annemans, Lieven; Benhalima, Katrien; Simoens, Steven; Verhaeghe, Nick
• Is Part Of: European journal of public health. Volume 30:Number 3(2020)
• Page Start: 396
• Page End: 401
• Publication Date: 2019-10-30
• Subjects: Epidemiology -- Europe -- Periodicals; Public health -- Europe -- Periodicals; 362.109405
• DOI: 10.1093/eurpub/ckz196
• Languages: English
• ISSNs: 1101-1262

Abstract

Abstract: Background: To compare estimated costs and health outcomes of lifestyle interventions for the prevention of type 2 diabetes mellitus in women who had gestational diabetes. Methods: An age-specific Markov model was applied comparing costs and quality-adjusted life years (QALYs) of three alternatives: 'doing nothing'; an annual reminder system (ARS) with an awareness campaign ('ARS-awareness'); and an ARS with an intensive lifestyle intervention ('ARS-ILS'). A healthcare payer perspective was adopted, the time horizon was 30 years and the setting was Flanders (Belgium). Sensitivity analyses were performed. Results: 'ARS-awareness' was extendedly dominated. Per 10 000 participants, 'ARS-ILS' cost €13 210 256 more and gained 496 QALYs compared with 'doing nothing' (26 632 €/QALY), with a 63% probability of being cost effective, given a cost effectiveness threshold of 35 000 €/QALY. A scenario analysis showed that 'ARS-ILS' for 15 years only offered to women with prediabetes (compared with 'doing nothing') has an 89.5% likelihood of being dominant. Conclusions: 'ARS-ILS' may be the preferred intervention. However, the probability of being cost effective was low. Based on further scenario analyses, we recommend healthcare decision makers to consider the application of a more intensive alternative, focused on the highest risk profiles and with a shorter intervention duration.