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Gillespie, P,O'Shea, E,Paul, G,O'Dowd, T,Smith, SM
International Journal Of Technology Assessment In Health Care
Cost Effectiveness of Peer Support for Type 2 Diabetes
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Type 2 diabetes Peer support General practice Cost-effectiveness analysis BLOOD-PRESSURE CONTROL COMPLICATIONS TRIAL UKPDS
Objectives: the aim of this study is to examine the cost-effectiveness of a group-based peer support intervention in general practice for patients with type 2 diabetes.Methods: Incremental cost utility analysis combining within trial and beyond trial components to compare the lifetime costs and benefits of alternative strategies: Control: standardized diabetes care; Intervention: group-based peer support in addition to standardized diabetes care. Within trial analysis was based on a cluster randomized controlled trial of 395 patients with type 2 diabetes in the east of Ireland. Beyond trial analysis was conducted using the United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model. Uncertainty was explored using a range of sensitivity analyses and cost-effectiveness acceptability curves were generated.Results: Compared with the control strategy, the intervention was associated with an increase of 0.09 (95 percent confidence interval [Cl], -0.05 to 0.25) in mean quality-adjusted life-years per patient and savings of (sic)637.43 (95 percent CI, -2455.19 to 1125.45) in mean healthcare cost per patient and (sic)623.39 (95 percent CI, -2507.98 to 1298.49) in mean total cost per patient respectively. The likelihood of the intervention being cost-effective was appreciably higher than 80 percent for a range of potential willingness-to-pay cost-effectiveness thresholds.Conclusions: Our results suggest that while a group-based peer support intervention shows a trend toward improved risk factor management, we found no significant differences in final cost or effectiveness endpoints between intervention and control. The probabilistic results suggest that the intervention was more cost-effective, with probability values of higher than 80 percent across a range of potential cost-effectiveness threshold values.
DOI 10.1017/S0266462311000663
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