A cost-effectiveness analysis alongside trial of a digital health-supported and community pharmacy-based prediabetes...

This study assessed the cost-effectiveness of a digital health-supported and community pharmacy-based lifestyle intervention (PRIME) programme for individuals with prediabetes in Malaysia over a 6-month period.

A trial-based cost-effectiveness study with a 6-month time horizon was conducted. Ninety-one participants (intervention, n = 46; usual care, n = 45) across 13 community pharmacies were included. The intervention group received in-depth counselling from pharmacists, in-app prediabetes education modules and peer support, while the usual care group received counselling based on pharmacists' usual practice. The primary outcome was quality-adjusted life years (QALY). Incremental cost-effectiveness ratios (ICER) per QALY gained of the intervention were compared with usual care from healthcare and societal perspectives. Non-parametric bootstrapping was used to examine uncertainty.

At 6months, the QALY achieved was 0.467 (95% CI 0.456 to 0.479) in the intervention group and 0.466 (95% CI 0.451 to 0.482) in the usual care group, resulting in a net gain of 0.005 QALY (95% CI -0.017 to 0.026) in the intervention group. The incremental healthcare and societal costs were US$6.10 (95% CI $5.33 to $6.88) and $10.69 (95% CI $6.03 to $15.35), respectively. From a healthcare perspective, the ICER per QALY gained was $1354, with a probability of 69.2% being cost-effective, while the corresponding figures were $2371 and 67.7% from a societal perspective. Results were below the willingness-to-pay threshold at $11 845 and were robust to sensitivity analyses.

A community pharmacy-based and digital health-supported lifestyle intervention to manage prediabetes may be cost-effective compared with usual care in Malaysia over a 6-month period.