The cost-effectiveness of interventions targeting lifestyle change for the prevention of diabetes in a Swedish primary care and community based prevention program

Anne Neumann (), Lars Lindholm, Margareta Norberg, Olaf Schoffer, Stefanie J. Klug and Fredrik Norström
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Anne Neumann: Umeå University
Lars Lindholm: Umeå University
Margareta Norberg: Umeå University
Olaf Schoffer: Technische Universität Dresden
Stefanie J. Klug: Technische Universität Dresden
Fredrik Norström: Umeå University

The European Journal of Health Economics, 2017, vol. 18, issue 7, No 9, 905-919

Abstract: Abstract Background Policymakers need to know the cost-effectiveness of interventions to prevent type 2 diabetes (T2D). The objective of this study was to estimate the cost-effectiveness of a T2D prevention initiative targeting weight reduction, increased physical activity and healthier diet in persons in pre-diabetic states by comparing a hypothetical intervention versus no intervention in a Swedish setting. Methods A Markov model was used to study the cost-effectiveness of a T2D prevention program based on lifestyle change versus a control group where no prevention was applied. Analyses were done deterministically and probabilistically based on Monte Carlo simulation for six different scenarios defined by sex and age groups (30, 50, 70 years). Cost and quality adjusted life year (QALY) differences between no intervention and intervention and incremental cost-effectiveness ratios (ICERs) were estimated and visualized in cost-effectiveness planes (CE planes) and cost-effectiveness acceptability curves (CEA curves). Results All ICERs were cost-effective and ranged from 3833 €/QALY gained (women, 30 years) to 9215 €/QALY gained (men, 70 years). The CEA curves showed that the probability of the intervention being cost-effective at the threshold value of 50,000 € per QALY gained was very high for all scenarios ranging from 85.0 to 91.1%. Discussion/conclusion The prevention or the delay of the onset of T2D is feasible and cost-effective. A small investment in healthy lifestyle with change in physical activity and diet together with weight loss are very likely to be cost-effective.

Keywords: Markov model; Cost-effectiveness; Diabetes; Prevention; Lifestyle change (search for similar items in EconPapers)
JEL-codes: I1 (search for similar items in EconPapers)
Date: 2017
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Citations: View citations in EconPapers (2)

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DOI: 10.1007/s10198-016-0851-9

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