Nurse-Led Telephone Program for Nonadherent to Treatment Type 2 Diabetics With Comorbid Depression: A Cost-Consequence and Budget Impact Analysis

Objective: To estimate the efficiency of a nurse-led telephone program for nonadherent to treatment Type 2 diabetics with comorbid depression (TELE-DD program). Design: Secondary analysis of cost-consequence and budget impact, utilizing data from a randomized clinical trial conducted in the primary healthcare setting. The target population consisted of Type 2 diabetic patients with comorbid depression who were nonadherent to their pharmacological treatment. Method: The average cost per controlled patient (glycated hemoglobin < 7%) and the incremental cost-effectiveness ratio were calculated. Similarly, the budgetary impact over 1 year of implementing this program in the region of reference of the randomized clinical trial was assessed. Results: The number of controlled patients is higher in the TELE-DD group at 6, 12, and 18 months. The average cost per controlled patient was higher in the TELE-DD group than in the control group at 6 months (<euro>160.31 vs. <euro>49.79), but lower at 12 (<euro>150.09 vs. <euro>179.59) and 18 months (<euro>209.22 vs. <euro>376.88). The incremental cost-effectiveness ratio at 6, 12, and 18 months was <euro>254.47, <euro>143.65, and <euro>177.46, respectively. The budget impact analysis revealed that implementing the TELE-DD program would result in a reduction of <euro>721,940.68 in expenditure for the funder in the first year of application. Conclusions: A nurse-led telephone program for nonadherent Type 2 diabetics with comorbid depression is an efficient option in the management of healthcare resources. These results highlight the role of nursing in chronic patient management and the efficient use of healthcare resources. Trial Registration: ClinicalTrials.gov Identifier: NCT04097483.