Abstract
AimTo analyse the cost‐effectiveness of different interventions for Type 2 diabetes prevention within a common framework.MethodsA micro‐simulation model was developed to evaluate the cost‐effectiveness of a range of diabetes prevention interventions including: (1) soft drinks taxation; (2) retail policy in socially deprived areas; (3) workplace intervention; (4) community‐based intervention; and (5) screening and intensive lifestyle intervention in individuals with high diabetes risk. Within the model, individuals follow metabolic trajectories (for BMI, cholesterol, systolic blood pressure and glycaemia); individuals may develop diabetes, and some may exhibit complications of diabetes and related disorders, including cardiovascular disease, and eventually die. Lifetime healthcare costs, employment costs and quality‐adjusted life‐years are collected for each person.ResultsAll interventions generate more life‐years and lifetime quality‐adjusted life‐years and reduce healthcare spending compared with doing nothing. Screening and intensive lifestyle intervention generates greatest lifetime net benefit (£37) but is costly to implement. In comparison, soft drinks taxation or retail policy generate lower net benefit (£11 and £11) but are cost‐saving in a shorter time period, preferentially benefit individuals from deprived backgrounds and reduce employer costs.ConclusionThe model enables a wide range of diabetes prevention interventions to be evaluated according to cost‐effectiveness, employment and equity impacts over the short and long term, allowing decision‐makers to prioritize policies that maximize the expected benefits, as well as fulfilling other policy targets, such as addressing social inequalities.
Highlights
Over 35% of adults in England are thought to be at high risk of developing type 2 diabetes because of impaired glucose regulation [1], defined by the American Diabetes Association as HbA1c concentrations of 39–46 mmol/mol (5.7–6.4%)
The model enables a wide range of diabetes prevention interventions to be evaluated according to costeffectiveness, employment and equity impacts over the short and long term, allowing decision-makers to prioritize policies that maximize the expected benefits, as well as fulfilling other policy targets, such as addressing social inequalities
Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK
Summary
Over 35% of adults in England are thought to be at high risk of developing type 2 diabetes because of impaired glucose regulation [1], defined by the American Diabetes Association as HbA1c concentrations of 39–46 mmol/mol (5.7–6.4%). For obese/overweight individuals and lifestyle promotion through fiscal or media campaigns [5]; because of differences in model structure it is not possible to compare interventions across studies and no study has directly compared the cost-effectiveness of intensive lifestyle intervention for individuals at high risk of diabetes within broader weight loss policies in a single modelling framework or estimated how outcomes are distributed across socio-economic groups.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
