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Cost-effectiveness analysis of point-of-care A1C tests in the primary care setting of Iran
Abdoreza Mousavi1, Mehdi Raadabadi2, Ali Darvishi3,4
1Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Background:
Given the critical role of timely monitoring in diabetes management, effective and accessible testing strategies are increasingly vital. This study evaluated the cost-effectiveness of point-of-care A1c (POC-A1c) testing compared with traditional laboratory-based A1c testing in primary care settings in Iran.
Research Design And Methods:
A lifetime (40 year) Markov model was developed to estimate expected costs (valued in 2023 PPP-adjusted US dollars), quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs) for the two strategies. Deterministic and probabilistic sensitivity analyses were performed to assess uncertainty in key model parameters.
Results:
POC-A1C was associated with an incremental cost of US$1,647.76 and a 0.15 QALY gain versus traditional laboratory testing, yielding an ICER of US$10,717.27 per QALY. Consequently, it was cost-effective at a willingness-to-pay threshold equal to Iran's 2023 per capita GDP. Also, based on probabilistic sensitivity analysis, the probability of POC-A1C being cost-effective was 58%.
Conclusions:
These findings suggest that integrating POC-A1c testing into primary care may represent a valuable strategy for strengthening diabetes management in Iran. While associated with higher direct costs, its potential to improve glycemic control and long-term health outcomes supports consideration by policymakers, particularly in the context of expanding access to timely diabetes monitoring.
