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Title: Cost-effectiveness of a pragmatic structured education intervention for the prevention of type 2 diabetes: economic evaluation of data from the Let's Prevent Diabetes cluster-randomised controlled trial.
Authors: Leal, J.
Ahrabian, D.
Davies, M. J.
Gray, L. J.
Khunti, K.
Yates, T.
Gray, A. M.
First Published: 1-Jan-2017
Publisher: BMJ Publishing Group:
Citation: BMJ Open, 2017;7:e013592.
Abstract: OBJECTIVES: Prevention of type 2 diabetes mellitus (TD2M) is a priority for healthcare systems. We estimated the cost-effectiveness compared with standard care of a structured education programme (Let's Prevent) targeting lifestyle and behaviour change to prevent progression to T2DM in people with prediabetes. DESIGN: Cost-effectiveness analysis alongside randomised controlled trial. SETTING: 44 general practices in Leicestershire, England. PARTICIPANTS: 880 participants with prediabetes randomised to receive either standard care or a 6-hour group structured education programme with follow-up sessions in a primary care setting. MAIN OUTCOME MEASURE: Incremental cost utility from the UK National Health Service (NHS) perspective. Quality of life and resource use measured from baseline and during the 36 months follow-up using the EuroQoL EQ-5D and 15D instruments and an economic questionnaire. Outcomes measured using quality-adjusted life years (QALYs) and healthcare costs calculated in 2012-2013 prices. RESULTS: After accounting for clustering and missing data, the intervention group was found to have a net gain of 0.046 (95% CI -0.0171 to 0.109) QALYs over 3 years, adjusted for baseline utility, at an additional cost of £168 (95% CI -395 to 732) per patient compared with the standard care group. The incremental cost-effectiveness ratio is £3643/QALY with an 86% probability of being cost-effective at a willingness to pay threshold of £20 000/QALY. CONCLUSIONS: The education programme had higher costs and higher quality of life compared with the standard care group. The Let's Prevent programme is very likely to be cost-effective at a willingness to pay threshold of £20 000/QALY gained. TRIAL REGISTRATION NUMBER: ISRCTN80605705.
DOI Link: 10.1136/bmjopen-2016-013592
eISSN: 2044-6055
Version: Publisher Version
Status: Peer-reviewed
Type: Journal Article
Rights: Copyright © the authors, 2017. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-commercial License (, which permits unrestricted use, distribution, and reproduction in any medium non-commercially, provided the original author and source are credited.
Description: Prepublication history and additional material is available. To view please visit the journal (
Appears in Collections:Published Articles, Dept. of Cardiovascular Sciences

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