Jacobs-van der Bruggen, Monique A.M., van Baal, Pieter H., Hoogenveen, Rudolf T., Feenstra, Talitha L., Briggs, Andrew H., Lawson, Kenny, Feskens, Edith J.M., and Baan, Caroline A. (2009) Cost-effectiveness of lifestyle modification in diabetic patients. Diabetes Care, 32 (8). pp. 1453-1458.

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Abstract

OBJECTIVE: To explore the potential long-term health and economic consequences of lifestyle interventions for diabetic patients.

RESEARCH DESIGN AND METHODS: A literature search was performed to identify interventions for diabetic patients in which lifestyle issues were addressed. We selected recent (2003–2008), randomized controlled trials with a minimum follow-up of 12 months. The long-term outcomes for these interventions, if implemented in the Dutch diabetic population, were simulated with a computer-based model. Costs and effects were discounted at, respectively, 4 and 1.5% annually. A lifelong time horizon was applied. Probabilistic sensitivity analyses were performed, taking account of variability in intervention costs and (long-term) treatment effects.

RESULTS: Seven trials with 147–5,145 participants met our predefined criteria. All interventions improved cardiovascular risk factors at ≥1 year follow-up and were projected to reduce cardiovascular morbidity over lifetime. The interventions resulted in an average gain of 0.01–0.14 quality-adjusted life-years (QALYs) per participant. Health benefits were generally achieved at reasonable costs (≤€50,000/QALY). A self-management education program (X-PERT) and physical activity counseling achieved the best results with ≥0.10 QALYs gained and ≥99% probability to be very cost-effective (≤€20,000/QALY).

CONCLUSIONS: Implementation of lifestyle interventions would probably yield important health benefits at reasonable costs. However, essential evidence for long-term maintenance of health benefits was limited. Future research should be focused on long-term effectiveness and multiple treatment strategies should be compared to determine incremental costs and benefits of one over the other.

Item ID:	36990
Item Type:	Article (Research - C1)
ISSN:	1935-5548
Additional Information:	Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
Date Deposited:	26 Feb 2015 00:56
FoR Codes:	14 ECONOMICS > 1402 Applied Economics > 140208 Health Economics @ 100%
SEO Codes:	92 HEALTH > 9202 Health and Support Services > 920207 Health Policy Evaluation @ 100%
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