Please use this identifier to cite or link to this item:
|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.|
Davies, M. J.
Gray, L. J.
Gray, A. M.
|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.|
|Rights:||Copyright © the authors, 2017. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-commercial License (https://creativecommons.org/licenses/by-nc/4.0/), 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 (http://dx.doi.org/10.1136/bmjopen-2016-013592).|
|Appears in Collections:||Published Articles, Dept. of Cardiovascular Sciences|
Files in This Item:
|bmjopen-2016-013592.pdf||Published (publisher PDF)||879.57 kB||Adobe PDF||View/Open|
Items in LRA are protected by copyright, with all rights reserved, unless otherwise indicated.