Long-term cost-effectiveness of health behaviour intervention to manage type 2 diabetes in Nepal

被引：0

作者：

Dahal, Padam Kanta ^{[1
,2
]}

Vandelanotte, Corneel ^{[2
]}

Rawal, Lal ^{[1
,2
,3
]}

Mahumud, Rashidul Alam ^{[4
]}

Paudel, Grish ^{[1
,2
]}

Lloyd, Melanie ^{[5
,6
]}

Baek, Yeji ^{[5
,6
]}

Karmacharya, Biraj ^{[7
]}

Sugishita, Tomohiko ^{[8
]}

Ademi, Zanfina ^{[5
,6
]}

机构：

[1] Cent Queensland Univ, Sch Hlth Med & Appl Sci, Sydney Campus,400 Kent St, Rockhampton, NSW 2000, Australia

[2] Cent Queensland Univ, Appleton Inst, Phys Act Res Grp, Biloela, Qld, Australia

[3] Western Sydney Univ, Translat Hlth Res Inst THRI, Sydney, NSW, Australia

[4] Univ Sydney, Fac Med & Hlth, NHMRC Clin Trials Ctr, Camperdown, NSW, Australia

[5] Monash Univ, Fac Pharm & Pharmaceut Sci, Ctr Med Use & Safety, Hlth Econ & Policy Evaluat Res HEPER Grp, Melbourne, Australia

[6] Monash Univ, Sch Publ Hlth & Prevent Med, Melbourne, Australia

[7] Kathmandu Univ Hosp, Dept Community Med, Dhulikhel, Nepal

[8] Tokyo Womens Med Univ, Dept Hyg & Publ Hlth, Sect Global Hlth, Tokyo, Japan

来源：

BMC MEDICINE | 2025年 / 23卷 / 01期

关键词：

Type; 2; diabetes; Long-term cost-effectiveness; Markov modelling; Health behaviour intervention; ECONOMIC-EVALUATION; PRIMARY-CARE; SERVICES; RISK; PREVENTION; MELLITUS;

D O I：

10.1186/s12916-025-03981-8

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BackgroundLong-term cost-effectiveness analyses of health behaviour interventions to effectively manage type 2 diabetes mellitus (T2DM) in low-income countries are crucial for minimising economic burden and optimising resource allocation. Therefore, this study aimed to estimate the long-term cost-effectiveness of implementing a health behaviour intervention to manage T2DM in Nepal.MethodsA Markov model in combination with a decision tree was developed to compare the costs and outcomes of the health behaviour intervention against usual care among 481 (238-intervention and 243-control) participants from healthcare system and societal perspectives. The model integrates empirical trial data, with published data to inform parameters not collected during the trial. The model estimated costs, quality-adjusted life years (QALYs) and cost-effectiveness over 5 years, 10 years, 20 years, 30 years and a lifetime time horizons with 3% annual discounting. Sub-group, scenarios, both one-way and two-way analyses and probabilistic sensitivity analyses (PSA) were performed to assess the impact of uncertainty in the model under the threshold of 3 times gross domestic product (GDP) per capita (i.e., US $4140) for Nepal.ResultsBase-case analysis with lifetime horizon showed that the health behaviour intervention compared to usual care improved QALYs by 3.88 and increased costs by US $4293 per patient, with an incremental cost-effectiveness ratio (ICER) of US $1106 per QALY gained from a healthcare system perspective. From a societal perspective, QALYs also improved by 3.88 and costs increased by US $4550, with an ICER of US $1173 per QALY gained. Furthermore, the intervention demonstrated ICERs of US $636, US $678, US $637, and US $632 per QALY gained over 5-, 10-, 20-, and 30-year time horizons, respectively, from a healthcare system perspective, and US $719, US $766, US $659, and US $716 per QALY gained from a societal perspective. In the PSA, the probability of the health behaviour intervention being cost-effective was over 57%.ConclusionsThe health behaviour intervention for managing T2DM was cost-effective over a lifetime horizon compared to usual care. To maximise its impact, this intervention should be scaled up nationwide, and future research is warranted to assess the long-term cost-effectiveness across diverse settings in low-income countries.Trial registrationAustralia and New Zealand Clinical Trial Registry (ACTRN12621000531819).

引用

页数：12