Five-year cost-effectiveness of Patient Empowerment Programme (PEP) for type 2 diabetes mellitus in primary care

Abstract

This study evaluated the short-term cost-effectiveness of the Patient Empowerment Programme (PEP) for diabetes mellitus in Hong Kong. Propensity score matching was used to select a matched group of PEP and non-PEP subjects. A societal perspective was adopted to estimate the cost of PEP. The outcome measures were the cumulative incidence of all-cause mortality and diabetic complication over a five-year follow-up and the number needed to treat (NNT) to avoid one event. The incremental cost-effectiveness ratio (ICER) of cost per event avoided was calculated using the PEP cost per subject multiplied by the NNT. The PEP cost per subject from the societal perspective was US$247. There was a significantly lower cumulative incidence of all-cause mortality (2.9% vs 4.6%, p < 0.001), any diabetic complication (9.5% vs 10.8%, p = 0.001) and CVD events (6.8% vs 7.6%, p = 0.018), in the PEP group. The costs per death from any cause, DM complication or case of CVD avoided were US$14,465, US$19,617 and US$30,796, respectively. The extra amount allocated to running PEP was small and it appears cost-effective in the short-term as an addition to RAMP.