Cost-effectiveness of the SLIMMER diabetes prevention intervention in Dutch primary health care: economic evaluation from a randomised controlled trial

Autor: G. Ardine de Wit, Geerke Duijzer, Judith Heinrich, Gerrit J Hiddink, Edith J. M. Feskens, Aafke Meints-Groenveld, Sophia C Jansen, Andrea J. Bukman, Annemien Haveman-Nies
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
Lifestyle intervention
Nutrition and Disease
Cost effectiveness
Cost-Benefit Analysis
General Practice
Psychological intervention
WASS
law.invention
Health administration
0302 clinical medicine
Randomized controlled trial
law
Voeding en Ziekte
Surveys and Questionnaires
Health care
Outcome Assessment
Health Care
Medicine
030212 general & internal medicine
Consumption and Healthy Lifestyles
health care economics and organizations
Human Nutrition & Health
Netherlands
030503 health policy & services
Health Policy
lcsh:Public aspects of medicine
Humane Voeding & Gezondheid
Diabetes
Middle Aged
Consumptie en Gezonde Leefstijl
Female
Quality-Adjusted Life Years
0305 other medical science
Research Article
Adult
medicine.medical_specialty
Strategic Communication
Strategische Communicatie
03 medical and health sciences
Journal Article
Humans
Healthy Lifestyle
VLAG
Aged
Retrospective Studies
Global Nutrition
Wereldvoeding
Primary Health Care
business.industry
Public health
Prevention
lcsh:RA1-1270
Economic evaluation
Quality-adjusted life year
Diabetes Mellitus
Type 2
Physical therapy
Quality of Life
Cost-effectiveness
Health Expenditures
business
Zdroj: BMC Health services research 19 (2019) 1
BMC Health Services Research
BMC Health Services Research, Vol 19, Iss 1, Pp 1-10 (2019)
BMC Health services research, 19(1)
BMC Health Services Research, 19(1). BioMed Central
ISSN: 1472-6963
Popis: Background Although evidence is accumulating that lifestyle modification may be cost-effective in patients with prediabetes, information is limited on the cost-effectiveness of interventions implemented in public health and primary health care settings. Evidence from well-conducted pragmatic trials is needed to gain insight into the realistic cost-effectiveness of diabetes prevention interventions in real-world settings. The aim of this study is to assess the cost-effectiveness of the SLIMMER lifestyle intervention targeted at patients at high risk of developing type 2 diabetes compared with usual health care in a primary care setting in the Netherlands. Methods Three hundred and sixteen high-risk subjects were randomly assigned to the SLIMMER lifestyle intervention or to usual health care. Costs and outcome assessments were performed at the end of the intervention (12 months) and six months thereafter (18 months). Costs were assessed from a societal perspective. Patients completed questionnaires to assess health care utilisation, participant out-of-pocket costs, and productivity losses. Quality Adjusted Life Years (QALY) were calculated based on the SF-36 questionnaire. Cost-effectiveness planes and acceptability curves were generated using bootstrap analyses. Results The cost-effectiveness analysis showed that the incremental costs of the SLIMMER lifestyle intervention were €547 and that the incremental effect was 0.02 QALY, resulting in an incremental cost-effectiveness ratio (ICER) of €28,094/QALY. When cost-effectiveness was calculated from a health care perspective, the ICER decreased to €13,605/QALY, with a moderate probability of being cost-effective (56% at a willingness to pay, WTP, of €20,000/QALY and 81% at a WTP of €80,000/QALY). Conclusions The SLIMMER lifestyle intervention to prevent type 2 diabetes had a low to moderate probability of being cost-effective, depending on the perspective taken. Trial registration The SLIMMER study is retrospectively registered with ClinicalTrials.gov (Identifier NCT02094911) since March 19, 2014.
Databáze: OpenAIRE
Externí odkaz: