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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| Format: | Article |
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Nature Portfolio
2025-03-01
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| Series: | Nature Communications |
| Online Access: | https://doi.org/10.1038/s41467-025-58120-x |
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| author | Yanshang Wang Dan Guo Yiqi Xia Mingzheng Hu Ming Wang Zhenyu Shi Xiaolong Guan Dawei Zhu Ping He |
| author_facet | Yanshang Wang Dan Guo Yiqi Xia Mingzheng Hu Ming Wang Zhenyu Shi Xiaolong Guan Dawei Zhu Ping He |
| author_sort | Yanshang Wang |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-47342d8ec76f4eecad1631df0433c3fc |
| institution | DOAJ |
| issn | 2041-1723 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Nature Portfolio |
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| spelling | doaj-art-47342d8ec76f4eecad1631df0433c3fc2025-08-20T03:18:34ZengNature PortfolioNature Communications2041-17232025-03-0116111010.1038/s41467-025-58120-xCost-effectiveness of community-based integrated care model for patients with diabetes and depressive symptomsYanshang Wang0Dan Guo1Yiqi Xia2Mingzheng Hu3Ming Wang4Zhenyu Shi5Xiaolong Guan6Dawei Zhu7Ping He8School of Public Health, Peking UniversityDepartment of Research and Teaching, China Aerospace Science & Industry Corporation 731 HospitalSchool of Public Health, Peking UniversitySchool of Public Health, Peking UniversitySchool of Public Health, Peking UniversitySchool of Public Health, Peking UniversitySchool of Public Health, Peking UniversitySchool of Pharmaceutical Sciences, Peking UniversityChina Center for Health Development Studies, Peking UniversityAbstract 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.https://doi.org/10.1038/s41467-025-58120-x |
| spellingShingle | Yanshang Wang Dan Guo Yiqi Xia Mingzheng Hu Ming Wang Zhenyu Shi Xiaolong Guan Dawei Zhu Ping He Cost-effectiveness of community-based integrated care model for patients with diabetes and depressive symptoms Nature Communications |
| title | Cost-effectiveness of community-based integrated care model for patients with diabetes and depressive symptoms |
| title_full | Cost-effectiveness of community-based integrated care model for patients with diabetes and depressive symptoms |
| title_fullStr | Cost-effectiveness of community-based integrated care model for patients with diabetes and depressive symptoms |
| title_full_unstemmed | Cost-effectiveness of community-based integrated care model for patients with diabetes and depressive symptoms |
| title_short | Cost-effectiveness of community-based integrated care model for patients with diabetes and depressive symptoms |
| title_sort | cost effectiveness of community based integrated care model for patients with diabetes and depressive symptoms |
| url | https://doi.org/10.1038/s41467-025-58120-x |
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