The cost-effectiveness of hospital-based telephone coaching for people with type 2 diabetes: a 10 year modelling analysis
Open accessAbstract
BACKGROUND: Type 2 diabetes (T2DM) is a burdensome condition for individuals to live with and an increasingly costly condition for health services to treat. Cost-effective treatment strategies are required to delay the onset and slow the progression of diabetes related complications. The Diabetes Telephone Coaching Study (DTCS) demonstrated that telephone coaching is an intervention that may improve the risk factor status and diabetes management practices of people with T2DM. Measuring the cost effectiveness of this intervention is important to inform funding decisions that may facilitate the translation of this research into clinical practice. The purpose of this study is to assess the cost-effectiveness of telephone coaching, compared to usual diabetes care, in participants with poorly controlled T2DM. METHODS: A cost utility analysis was undertaken using the United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model to extrapolate outcomes collected at 6 months in the DTCS over a 10 year time horizon. The intervention's impact on life expectancy, quality-adjusted life expectancy (QALE) and costs was estimated. Costs were reported from a health system perspective. A 5 % discount rate was applied to all future costs and effects. One-way sensitivity analyses were conducted to reflect uncertainty surrounding key input parameters. RESULTS: The intervention dominated the control condition in the base-case analysis, contributing to cost savings of $3327 per participant, along with non-significant improvements in QALE (0.2 QALE) and life expectancy (0.3 years). CONCLUSIONS: The cost of delivering the telephone coaching intervention continuously, for 10 years, was fully recovered through cost savings and a trend towards net health benefits. Findings of cost savings and net health benefits are rare and should prove attractive to decision makers who will determine whether this intervention is implemented into clinical practice. TRIAL REGISTRATION: ACTRN12609000075280.
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Two full economic evaluations using one mHealth technology reported cost per QALY gained values of 0.9% and 0.4% of their respective countries' GDP per capita.
“Of these, the two studies that used one mHealth technology reported cost per QALY gained had values of 0.9% and 0.4% of their respective countries' GDP per capita [36,37].”
From Cost and cost-effectiveness of mHealth interventions for the prevention and control of type 2 diabetes mellitus: A systematic review (2020) · cites this paper as [37]
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- Authors
- Varney, J. E., Liew, D., Weiland, T. J., Inder, W. J., & Jelinek, G. A.
- Affiliations
- The Alfred Hospital (AU)
- The University of Melbourne (AU)
- The University of Queensland (AU)
- Corresponding author
- Varney, J. E.
- Venue
- BMC Health Services Research
- Published
- 2016-09-27
- Volume
- 16
- Issue
- 1
- Pages
- 521-521
- ISSN
- 1472-6963 (ISSN-L)
- PMC
- PMC5039787
- OpenAlex
- W2527023777
- Cited by
- 21
- References
- 43
- Citations by year
- 2024: 2 · 2023: 2 · 2022: 4 · 2021: 3 · 2020: 5 · 2019: 3 · 2018: 2
- FWCI
- 3.24
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Health Services Research (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Monash University Research Portal (Monash University) (submittedVersion, other-oa)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- type 2 diabetes, telephone coaching, cost-effectiveness, diabetes self-management, quality-adjusted life expectancy, life expectancy, uncontrolled diabetes, health care costs
- MeSH terms
- Mentoring, Adult, Cost-Benefit Analysis, Diabetes Mellitus, Type 2, Economics, Hospital, Female, United Kingdom, Glycated Hemoglobin, Humans, Male, Middle Aged, Prospective Studies, Quality of Life, Risk Factors, Telephone, Victoria, Health Care Costs, Outcome Assessment, Health Care, Telemedicine, Home Care Services, Hospital-Based, Quality-Adjusted Life Years, Diabetes Complications
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