Cost-Effectiveness Analysis of Efforts to Reduce Risk of Type 2 Diabetes and Cardiovascular Disease in Southwestern Pennsylvania, 2005-2007

Details

• Journal Article:
  Preventing Chronic Disease (PCD)
• Personal Author:
  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.
• 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

  More +
• Source:
  Prev Chronic Dis. 7(5).
• ISSN:
  1545-1151
• Document Type:
  Journal Article
• Place as Subject:
  Pennsylvania
• Location:
  North America
• Volume:
  7
• Issue:
  5
• Collection(s):
  Preventing Chronic Disease
• Main Document Checksum:
  urn:sha-512:90bc83f9c45e0fcbb13e7c82c3511db029a673db709e397fa1a4f5f0520f2f108f657c985be60a074a6669b762ff4818f08c5c8ddc2f355776a25ff39ef58cba
• Download URL:
  https://stacks.cdc.gov/view/cdc/20499/cdc_20499_DS1.pdf
• File Type:
  [PDF - 492.48 KB ]