Affiliation:
1. Department of Health Policy and Management Tulane University School of Public Health and Tropical Medicine New Orleans Louisiana USA
2. Department of Health Policy and Management, Gillings School of Global Public Health University of North Carolina Chapel Hill North Carolina USA
3. Department of Health Policy and Management Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA
Abstract
AbstractAimTo assess the cost‐effectiveness of a digital diabetes prevention programme (d‐DPP) compared with a diabetes prevention programme (DPP) for preventing type 2 diabetes (T2D) in individuals with prediabetes in the United States.MethodsA Markov cohort model was constructed, simulating a 10‐year period starting at the age of 45 years, with a societal and healthcare sector perspective. The effectiveness of the d‐DPP intervention was evaluated using a meta‐analysis, with that of the DPP as the comparator. The initial cycle represented the treatment period, and transition probabilities for the post‐treatment period were derived from a long‐term lifestyle intervention meta‐analysis. The onset of T2D complications was estimated using microsimulation. Quality‐adjusted life years (QALYs) were calculated based on health utility measured by short form (SF)‐12 scores, and a willingness‐to‐pay threshold of $100 000 per QALY gained was applied.ResultsThe d‐DPP intervention resulted in cost savings of $3,672 from a societal perspective and $2,990 from a healthcare sector perspective and a gain of 0.08 QALYs compared with the DPP. The dropout rate was identified as a significant factor influencing the results. Probabilistic sensitivity analysis showed that the d‐DPP intervention was preferred in 85.8% in the societal perspective and 85.2% in the healthcare sector perspective.ConclusionsThe d‐DPP is a cost‐effective alternative to in‐person lifestyle interventions for preventing the development of T2D among individuals with prediabetes in the United States.