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A cost-effectiveness analysis of a community-based diabetes prevention program in Sweden

Published online by Cambridge University Press:  21 July 2009

Pia Johansson ,
Claes-Göran Östenson ,
Agneta M. Hilding ,
Camilla Andersson ,
Clas Rehnberg  and
Per Tillgren
Pia Johansson
Affiliation:
Karolinska Institutet
Claes-Göran Östenson
Affiliation:
Karolinska Institutet
Agneta M. Hilding
Affiliation:
Karolinska Institutet
Camilla Andersson
Affiliation:
Karolinska Institutet
Clas Rehnberg
Affiliation:
Karolinska Institutet
Per Tillgren
Affiliation:
Karolinska Institutet
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Abstract

Objectives: Lifestyle changes to prevent type 2 diabetes among high-risk persons have been shown to be cost-effective. This study investigates the cost-effectiveness of a community-based program promoting general population lifestyle changes to prevent diabetes.

Methods: The 10-year program was implemented in three municipalities in Sweden. Effectiveness was measured with a quasiexperimental cohort design, that is, risk factor levels in a population group aged 36–56 years at baseline and 8–10 years later (2,149 men; 3,092 women) in the program municipalities and a control area were compared. The incremental cost-utility analysis included future diabetes and cardiovascular disease-related health effects and societal costs (discounted 3 percent), estimated by a Markov model.

Results: In all areas, risk factor levels increased during follow-up, leading to increased societal costs of between SEK40,000 and 90,000 (1 Euro 2004 = SEK9.13; 1 US$ = SEK 7.35) and quality-adjusted life-year (QALY) losses between 0.12 and 0.48 per individual. Compared with the control area, the cost increases and QALY losses for women were more favorable in two program areas but less favorable in one, and less favorable for men in both areas (data unavailable for one municipality). The findings indicate that the program was cost-effective in only two female study groups.

Conclusions: Conflicting results on the cost-effectiveness of the program were obtained. As several potentially valuable aspects of the program are not included in the cost-effectiveness analysis, the societal value of the program might not be adequately reflected.

Keywords

EconomicsDiabetes mellitus type 2Metabolic syndromePrimary preventionLifestyle
Type
General Essays
Information
International Journal of Technology Assessment in Health Care , Volume 25 , Issue 3 , July 2009 , pp. 350 - 358
Copyright
Copyright © Cambridge University Press 2009

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