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Lifestyle intervention to prevent diabetes in men and women with impaired glucose tolerance is cost-effective

Published online by Cambridge University Press:  01 April 2007

Peter Lindgren ,
Jaana Lindström ,
Jaakko Tuomilehto ,
Matti Uusitupa ,
Markku Peltonen ,
Bengt Jönsson ,
Ulf de Faire  and
Mai-Lis Hellénius
Peter Lindgren
Affiliation:
Karolinska Institutet and European Health Economics
Jaana Lindström
Affiliation:
National Public Health Institute
Jaakko Tuomilehto
Affiliation:
University of Helsinki
Matti Uusitupa
Affiliation:
University of Kuopio
Markku Peltonen
Affiliation:
National Public Health Institute
Bengt Jönsson
Affiliation:
Stockholm School of Economics
Ulf de Faire
Affiliation:
Karolinska Institutet and Karolinska Hospital
Mai-Lis Hellénius
Affiliation:
Karolinska Institutet and Stockholm County Council
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Abstract

Objectives: The Finnish Diabetes Prevention Study (DPS) was a randomized intervention program that evaluated the effect of intensive lifestyle modification on the development of diabetes mellitus type 2 in patients with impaired glucose tolerance. As such, a program is demanding in terms of resources; it is necessary to assess whether it would be money well spent. This determination was the purpose of this study.

Methods: We developed a simulation model to assess the economic consequences of an intervention like the one studied in DPS in a Swedish setting. The model used data from the trial itself to assess the effect of intervention on the risk of diabetes and on risk factors for cardiovascular disease. Results from the United Kingdom Prospective Diabetes Study were used to estimate the risk of cardiovascular disease and stroke. Cost data were derived from Swedish studies. The intervention was assumed to be applied to eligible patients from a population-based screening program of 60-year-olds in the County of Stockholm from which the baseline characteristics of the patients was used.

Results: The model predicted that implementing the program would be cost-saving from the healthcare payers' perspective. Furthermore, it was associated with an increase in estimated survival of .18 years. Taking into consideration the increased consumption by patients due to their longer survival, the predicted cost-effectiveness ratio was 2,363€ per quality-adjusted life-year gained.

Conclusions: Lifestyle intervention directed toward high-risk subjects would be cost-saving for the healthcare payer and highly cost-effective for society as a whole.

Keywords

Diabetes mellitus type 2Primary preventionLifestyleGlucose intoleranceEconomics
Type
GENERAL ESSAYS
Information
International Journal of Technology Assessment in Health Care , Volume 23 , Issue 2 , April 2007 , pp. 177 - 183
Copyright
Copyright © Cambridge University Press 2007

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