The impact of Type 2 diabetes prevention programmes based on risk-identification and lifestyle intervention intensity strategies: A cost-effectiveness analysis

P. R. Breeze, C. Thomas, H. Squires, A. Brennan, C. Greaves, P. J. Diggle, E. Brunner, A. Tabák, L. Preston, J. Chilcott

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Aims: To develop a cost-effectiveness model to compare Type 2 diabetes prevention programmes targeting different at-risk population subgroups with a lifestyle intervention of varying intensity. Methods: An individual patient simulation model was constructed to simulate the development of diabetes in a representative sample of adults without diabetes from the UK population. The model incorporates trajectories for HbA1c, 2-h glucose, fasting plasma glucose, BMI, systolic blood pressure, total cholesterol and HDL cholesterol. Patients can be diagnosed with diabetes, cardiovascular disease, microvascular complications of diabetes, cancer, osteoarthritis and depression, or can die. The model collects costs and utilities over a lifetime horizon. The perspective is the UK National Health Service and personal social services. We used the model to evaluate the population-wide impact of targeting a lifestyle intervention of varying intensity to six population subgroups defined as high risk for diabetes. Results: The intervention produces 0.0003 to 0.0009 incremental quality-adjusted life years and saves up to £1.04 per person in the general population, depending upon the subgroup targeted. Cost-effectiveness increases with intervention intensity. The most cost-effective options are to target individuals with HbA1c > 42 mmol/mol (6%) or with a high Finnish Diabetes Risk (FINDRISC) probability score (> 0.1). Conclusion: The model indicates that diabetes prevention interventions are likely to be cost-effective and may be cost-saving over a lifetime. In the model, the criteria for selecting at-risk individuals differentially impact upon diabetes and cardiovascular disease outcomes, and on the timing of benefits. These findings have implications for deciding who should be targeted for diabetes prevention interventions.

Original languageEnglish
JournalDiabetic Medicine
DOIs
Publication statusAccepted/In press - 2017

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Type 2 Diabetes Mellitus
Cost-Benefit Analysis
Life Style
Costs and Cost Analysis
Population
Cardiovascular Diseases
Patient Simulation
Blood Pressure
Glucose
Quality-Adjusted Life Years
National Health Programs
Diabetes Complications
Social Work
Osteoarthritis
HDL Cholesterol
Fasting
Cholesterol
Depression
Neoplasms

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

The impact of Type 2 diabetes prevention programmes based on risk-identification and lifestyle intervention intensity strategies : A cost-effectiveness analysis. / Breeze, P. R.; Thomas, C.; Squires, H.; Brennan, A.; Greaves, C.; Diggle, P. J.; Brunner, E.; Tabák, A.; Preston, L.; Chilcott, J.

In: Diabetic Medicine, 2017.

Research output: Contribution to journalArticle

Breeze, P. R. ; Thomas, C. ; Squires, H. ; Brennan, A. ; Greaves, C. ; Diggle, P. J. ; Brunner, E. ; Tabák, A. ; Preston, L. ; Chilcott, J. / The impact of Type 2 diabetes prevention programmes based on risk-identification and lifestyle intervention intensity strategies : A cost-effectiveness analysis. In: Diabetic Medicine. 2017.
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