Cost-effectiveness analysis of a digital Diabetes Prevention Program (dDPP) in prediabetic patients

Author:

Park Sooyeol12ORCID,Ward Trevor1,Sudimack Andrew1,Cox Sam1,Ballreich Jeromie1ORCID

Affiliation:

1. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

2. Department of Health Policy and Management, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA

Abstract

Objectives To assess the cost-effectiveness of a digital Diabetes Prevention Program (dDPP) in preventing type 2 diabetes mellitus among prediabetic patients from a health system perspective over a 10-year time horizon. Methods A Markov cohort model was constructed to assess the cost-effectiveness of dDPP compared to a small group education (SGE) intervention. Transition probabilities for the first year of the model were derived from two clinical trials on dDPP. Transition probabilities for longer-term effects were derived from meta-analyses on lifestyle and Diabetes Prevention Program interventions. Cost and health utilities were derived from published literature. Partial completion of interventions was incorporated to provide a robust prediction of a real-world deployment. Parameter uncertainties were assessed using univariate and probabilistic sensitivity analyses. Cost-effectiveness was measured by an incremental cost-effectiveness ratio (ICER) between dDPP and SGE from a health system perspective over a 10-year time horizon. Results The dDPP dominated the SGE at the $50,000, $100,000, and $150,000 willingness-to-pay thresholds per quality-adjusted life years (QALYs). The base case analysis at the $100,000 willingness-to-pay threshold (WTP) revealed a dominated ICER, with the SGE costing $1332 more and accruing an average of 0.04 fewer QALYs. Probabilistic sensitivity analysis showed that the dDPP was preferred in 64.4% of simulations across the $100,000 WTP thresholds. Conclusions The findings comparing a dDPP to an SGE suggest that a dDPP can be cost-effective for patients with a high risk of developing type 2 diabetes.

Publisher

SAGE Publications

Subject

Health Informatics

Reference46 articles.

1. Self-Management Education for Adults With Type 2 Diabetes

2. Centers for Disease Control and Prevention. National Diabetes Statistics Report, https://www.cdc.gov/diabetes/data/statistics-report/index.html (2018, accessed 04.25 2022).

3. Economic Costs of Diabetes in the U.S. in 2017

4. Centers for Disease Control and Prevention. National Diabetes Prevention Program 2021, 2021.

5. A systematic review of real-world diabetes prevention programs: learnings from the last 15 years

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