Cost-effectiveness analysis of efforts to reduce risk of type 2 diabetes and cardiovascular disease in southwestern Pennsylvania, 2005-2007.

Autor: Smith KJ; University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA., Hsu HE, Roberts MS, Kramer MK, Orchard TJ, Piatt GA, Seidel MC, Zgibor JC, Bryce CL
Jazyk: angličtina
Zdroj: Preventing chronic disease [Prev Chronic Dis] 2010 Sep; Vol. 7 (5), pp. A109. Date of Electronic Publication: 2010 Aug 15.
Abstrakt: Introduction: We assessed the cost-effectiveness of a community-based, modified Diabetes Prevention Program (DPP) designed to reduce risk factors for type 2 diabetes and cardiovascular disease.
Methods: We developed a Markov decision model to compare costs and effectiveness of a modified DPP intervention with usual care during a 3-year period. Input parameters included costs and outcomes from 2 projects that implemented a community-based modified DPP for participants with metabolic syndrome, and from other sources. The model discounted future costs and benefits by 3% annually.
Results: At 12 months, usual care reduced relative risk of metabolic syndrome by 12.1%. A modified DPP intervention reduced relative risk by 16.2% and yielded life expectancy gains of 0.01 quality-adjusted life-years (3.67 days) at an incremental cost of $34.50 ($3,420 per quality-adjusted life-year gained). In 1-way sensitivity analyses, results were sensitive to probabilities that risk factors would be reduced with or without a modified DPP and that patients would enroll in an intervention, undergo testing, and acquire diabetes with or without an intervention if they were risk-factor-positive. Results were also sensitive to utilities for risk-factor-positive patients. In probabilistic sensitivity analysis, the intervention cost less than $20,000 per quality-adjusted life-year gained in approximately 78% of model iterations.
Conclusion: We consider the modified DPP delivered in community and primary care settings a sound investment.
Databáze: MEDLINE
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