Cost-effectiveness of community-based integrated care model for patients with diabetes and depressive symptoms

Abstract The coexistence of type 2 diabetes (T2DM) and depression is a prominent example of multimorbidity. In previous work, we reported the results of a completed cluster-randomized controlled trial that was conducted in eight community health centers in China. We enrolled adults (≥18 years) with...

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Bibliographic Details
Main Authors: Yanshang Wang, Dan Guo, Yiqi Xia, Mingzheng Hu, Ming Wang, Zhenyu Shi, Xiaolong Guan, Dawei Zhu, Ping He
Format: Article
Language:English
Published: Nature Portfolio 2025-03-01
Series:Nature Communications
Online Access:https://doi.org/10.1038/s41467-025-58120-x
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Summary:Abstract The coexistence of type 2 diabetes (T2DM) and depression is a prominent example of multimorbidity. In previous work, we reported the results of a completed cluster-randomized controlled trial that was conducted in eight community health centers in China. We enrolled adults (≥18 years) with type 2 diabetes and depressive symptoms. In the intervention group, a comprehensive care plan was developed based on the Integrated Care Model for Patients with Diabetes and Depression (CIC-PDD). In this study, we explore the cost-effectiveness of the CIC-PDD by conducting a one-year within-trial economic evaluation from the health system, multipayer and societal perspectives. Health outcomes are quality-adjusted life years (QALYs) and depression-free days (DFDs), and we calculate incremental cost-effectiveness ratios (ICERs) and cost-effectiveness probability. Among 630 participants (275 intervention, 355 usual care), the cost per QALY gained is $7,922.82, $7,823.85, and $7,409.46, with cost-effectiveness probabilities of 66.41%- 94.45%. The cost per DFD is $2.63–$2.82, requiring a willingness-to-pay of $9.00–$10.50 for >95% probability of cost-effectiveness. We find that the CIC-PDD model demonstrates cost-effectiveness within primary health care settings, but further studies are needed to assess its long-term sustainability and scalability. Trial registration: 35 ChiCTR2200065608.
ISSN:2041-1723