Cost-effectiveness of community-based integrated care model for patients with diabetes and depressive symptoms

Wanshang Wang, Dan Guo, Yiqi Xia, Mingzheng Hu, Ming Wang, Zhenyu Shi, Xiaolong Guan, Dawei Zhu and Ping He ()
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Wanshang Wang: Peking University
Dan Guo: China Aerospace Science & Industry Corporation 731 Hospital
Yiqi Xia: Peking University
Mingzheng Hu: Peking University
Ming Wang: Peking University
Zhenyu Shi: Peking University
Xiaolong Guan: Peking University
Dawei Zhu: Peking University
Ping He: Peking University

Nature Communications, 2025, vol. 16, issue 1, 1-10

Abstract: Abstract The coexistence of type 2 diabetes (T2DM) and depression is a prominent example of multimorbidity. In previous work, we reported the results of a completed cluster-randomized controlled trial that was conducted in eight community health centers in China. We enrolled adults (≥18 years) with type 2 diabetes and depressive symptoms. In the intervention group, a comprehensive care plan was developed based on the Integrated Care Model for Patients with Diabetes and Depression (CIC-PDD). In this study, we explore the cost-effectiveness of the CIC-PDD by conducting a one-year within-trial economic evaluation from the health system, multipayer and societal perspectives. Health outcomes are quality-adjusted life years (QALYs) and depression-free days (DFDs), and we calculate incremental cost-effectiveness ratios (ICERs) and cost-effectiveness probability. Among 630 participants (275 intervention, 355 usual care), the cost per QALY gained is $7,922.82, $7,823.85, and $7,409.46, with cost-effectiveness probabilities of 66.41%- 94.45%. The cost per DFD is $2.63–$2.82, requiring a willingness-to-pay of $9.00–$10.50 for >95% probability of cost-effectiveness. We find that the CIC-PDD model demonstrates cost-effectiveness within primary health care settings, but further studies are needed to assess its long-term sustainability and scalability. Trial registration: 35 ChiCTR2200065608.

Date: 2025
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DOI: 10.1038/s41467-025-58120-x

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