Details:

Alternative Title:
Prev Chronic Dis
Personal Author:
Smith, Kenneth J. ; Bryce, Cindy L. ; Hsu, Heather E. ; Roberts, Mark S. ; Kramer, M. Kaye ; ... More +
Smith, Kenneth J. ; Bryce, Cindy L. ; Hsu, Heather E. ; Roberts, Mark S. ; Kramer, M. Kaye ; Orchard, Trevor J. ; Piatt, Gretchen A. ; Seidel, Miriam C. ; Zgibor, Janice C. Less -
Description:
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.


Subjects:
[+]
Cardiovascular Diseases Community Health Services Cost-Benefit Analysis Decision Support Techniques Diabetes Mellitus, Type 2 Diet Humans Life Style Markov Chains Sensitivity And Specificity Time Factors
Source:
Prev Chronic Dis. 7(5).
Document Type:
Journal Article
Place as Subject:
Pennsylvania
Location:
North America
Collection(s):
Preventing Chronic Disease
Main Document Checksum:
[+]
urn:sha256:d2f9b3a7faad19d35905a2413c322ada163ab0d48745f024378fedcad4b3e967
Download URL:
https://stacks.cdc.gov/view/cdc/20499/cdc_20499_DS1.pdf
File Type:

Supporting Files

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