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Benchmarking the Cost-Effectiveness of Interventions Delaying Diabetes: A Simulation Study Based on NAVIGATOR Data
Jose Leal1, Shelby D Reed2, Rishi Patel3
1Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, U.K. jose.leal@dph.ox.ac.uk.
Diabetes Care
|August 16, 2020
Summary
Delaying type 2 diabetes onset by 1-9 years significantly increases quality-adjusted life years (QALYs) and reduces complication costs. This research guides cost-effective diabetes prevention strategies.
Area of Science:
- Endocrinology
- Health Economics
- Preventive Medicine
Background:
- Type 2 diabetes poses a significant health and economic burden globally.
- Early intervention strategies are crucial for managing diabetes and its complications.
- The NAVIGATOR trial provided data on individuals with impaired glucose tolerance, a precursor to type 2 diabetes.
Purpose of the Study:
- To estimate the impact of delaying the onset of type 2 diabetes on healthcare costs and quality-adjusted life expectancy.
- To determine the cost-effectiveness of interventions aimed at delaying diabetes onset.
- To inform the development of diabetes prevention strategies.
Main Methods:
- Utilized the UK Prospective Diabetes Study Outcomes Model Version 2 (UKPDS-OM2).
- Simulated delays in type 2 diabetes onset ranging from 1 to 9 years.
- Incorporated data from 3,058 NAVIGATOR trial participants who developed type 2 diabetes.
- Estimated discounted lifetime costs and quality-adjusted life years (QALYs) for U.S. and U.K. settings.
Main Results:
- A 1-year delay in diabetes onset increased QALYs by 0.02 in the U.S. setting.
- A 9-year delay increased QALYs by 0.15 and resulted in savings of $8,437 in complication costs.
- Interventions costing up to $2,680/year (U.S.) or £947/year (U.K.) were found to be cost-effective.
Conclusions:
- Simulating diabetes-delaying interventions provides valuable guidance on cost-effectiveness.
- Results inform the debate on diabetes prevention and the design of future intervention studies.
- Delaying type 2 diabetes onset is a cost-effective strategy with significant benefits for quality of life and healthcare economics.
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