IDF21-0201 Cost-utility of an online education platform and diabetes personal health record: Analysis over ten years

Abstract

Background: My Diabetes My Way (MDMW) is Scotland’s interactive website and mobile app for people with diabetes and carers. The aim of MDMW is to support people with their self-management, by providing an accessible resource that encourages active participation in routine care. The website contains multimedia resources for diabetes education and offers people with diabetes access to their electronic personal health record (ePHR), facilitating personalised advice. The MDMW ePHR contains test results from general practice, secondary care systems, labs and specialist screening systems, based on a clearly defined, patient-focused dataset. Aim: The purpose of this study is to assess the cost-utility of a data-driven education platform and ePHR for diabetes, compared to routine diabetes care. It focuses on a clearly defined cohort of people with type 2 diabetes who are not prescribed insulin. Method: Analysis used the United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model2. Clinical parameters of MDMW users (n = 2576) were compared with a matched cohort of individuals receiving routine care alone (n = 11,628). Matching criteria: age, diabetes duration, sex and socio-economic status. Impact on life expectancy, quality-adjusted life years (QALYs) and costs of treatment and complications were simulated over ten years, including a 10% sensitivity analysis. Results: MDMW cohort: 1,670 (64.8%) men; average age 64.3 years; duration of diabetes 5.5 years. 906 (35.2%) women: average age 61.6; duration 4.7 years. The cumulative mean QALY (95% CI) gain: 0.054 (0.044; 0.062) years. Mean difference in cost: −£118.72 (v£150.16; −£54.16) over ten years. Increasing MDMW costs (10%): −£50.49 (−£82.24; £14.14). Decreasing MDMW costs (10%): −£186.95 (−£218.53; −£122.51). Discussion: The result of this analysis indicates that use of MDMW is expected to be ‘dominant’ over usual care, (both cost-saving and life improving) in supporting self-management in people with type 2 diabetes not treated with insulin. Operating costs at the time of analysis were approximately £3.42 per registered diabetes patient per annum. This equates to a potential return on investment of well over 3:1 during a ten-year period based on the results shown from the UKPDS outcomes model. Wider use of the MDMW service could result in significant cost savings through delay or reduction of long-term complications and increased life expectancy in health care systems where it is used and adopted. This study demonstrates for the first time the potential of a low-cost, scalable digital intervention to deliver population-based benefits and cost savings.