Long-term cost-effectiveness of a Patient Empowerment Programme for Type 2 Diabetes Mellitus in primary care

Abstract

Aims: To evaluate the long‐term cost‐effectiveness of a Patient Empowerment Programme (PEP) for Type 2 Diabetes Mellitus (DM) in primary care Materials and methods: PEP participants were subjects with Type 2 DM who enrolled into PEP in addition to enrolment in the Risk Assessment and Management Programme for DM (RAMP‐DM) at primary care level. The comparison group was subjects who only enrolled into RAMP‐DM without participating in PEP (non‐PEP). A cost‐effectiveness analysis was conducted using a patient level simulation model (with fixed‐time increments) from a societal perspective. We incorporated the empirical data from a matched cohort of PEP and non‐PEP group to simulate lifetime costs and outcomes for subjects with DM with or without PEP. Incremental cost‐effectiveness ratios (ICER) in terms of cost per quality adjusted life year (QALY) gained were calculated. Probabilistic sensitivity analysis was conducted with results presented as a cost‐effectiveness acceptability curve. Results: With an assumption that the PEP effect would last for 5 years as shown by the empirical data, the incremental cost per subject was US$197 and the incremental QALYs gained were 0.06 per subject, which resulted in an ICER of US$3,290 per QALY gained compared with no PEP across the life time. Probabilistic sensitivity analysis showed 66% likelihood that PEP is cost‐effective compared with non‐PEP when willingness‐to‐pay (WTP) for a QALY is US$46,153 or above (based on per capita GDP 2017). Conclusions: Based on this carefully measured cost of PEP and its potentially large benefits, PEP could be highly cost‐effective from a societal perspective as an adjunct intervention for patients with DM.