PDB43 SYSTEMATIC REVIEW OF THE COST EFFECTIVENESS ANALYSIS OF LIFESTYLE INTERVENTION VERSUS STANDARD CARE FOR PREVENTION OF TYPE 2 DIABETES

Abstract

Several studies showed lifestyle intervention was effective and cost-effective to prevent type 2 diabetes compared to standard care. The aim of this study was to perform a systematic review of cost effectiveness of lifestyle intervention to determine if lifestyle intervention provide a good value for money compared to a standard care or placebo. A database search using the Cost-Effectiveness Analysis (CEA) registry was performed using the search terms ‘Diabetes prevention’, ‘Physical activity for diabetes prevention’, ‘Prevent diabetes’, ‘Prevent type 2 Diabetes’. To meet the inclusion criteria, a study needed to have Quality Adjusted Life Years (QALYs) as an outcome measure and intensive lifestyle intervention as the treatment against usual care or no intervention/ placebo. Moreover, it must be a cost effectiveness study where the study population was at risk of developing type 2 diabetes. Published studies that considered healthcare or/and societal perspective from 1996-2017 were included. Studies were excluded if lifestyle was not the intervention or outcome was not reported in QALYs. In total, 43 papers were identified. Duplicates were removed and 24 articles that met the inclusion criteria were selected by two independent reviewers and included in the final analysis. The median Incremental Cost Effectiveness Ratio (ICER) of lifestyle intervention versus standard care or placebo was $ 13,200/QALYs. We also reviewed the ICERs from a health care system and societal perspective. The ICER was 8,900/QALYs and 20,900/QALYs from Healthcare system and societal respectively. A willingness to pay $50,000 per QALYs was assumed as threshold and the median ICER was below that threshold. Therefore, lifestyle was identified as cost effective compared to a standard care or placebo. Lifestyle intervention was very cost effective and offers a good value of money compared to the standard care.