National health and economic impact of a lifestyle program to prevent type 2 diabetes mellitus in Germany: a simulation study

Introduction To examine the long-term health and economic impact of a lifestyle diabetes prevention program in people with high risk of developing type 2 diabetes in Germany.Research design and methods We assessed the lifetime cost-effectiveness of a 2-year pragmatic lifestyle program for preventing...

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Main Authors: Ping Zhang, Andrea Icks, Michael Laxy, Karl Emmert-Fees, Katherine Ogurtsova, Charalabos-Markos Dintsios
Format: Article
Language:English
Published: BMJ Publishing Group 2024-10-01
Series:BMJ Open Diabetes Research & Care
Online Access:https://drc.bmj.com/content/12/5/e004382.full
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author Ping Zhang
Andrea Icks
Michael Laxy
Karl Emmert-Fees
Katherine Ogurtsova
Charalabos-Markos Dintsios
author_facet Ping Zhang
Andrea Icks
Michael Laxy
Karl Emmert-Fees
Katherine Ogurtsova
Charalabos-Markos Dintsios
author_sort Ping Zhang
collection DOAJ
description Introduction To examine the long-term health and economic impact of a lifestyle diabetes prevention program in people with high risk of developing type 2 diabetes in Germany.Research design and methods We assessed the lifetime cost-effectiveness of a 2-year pragmatic lifestyle program for preventing type 2 diabetes targeting German adults aged 35–54 and 55–74 years old with hemoglobin A1c (HbA1c) from 6.0% to 6.4%. We used the Centers for Disease Control and Prevention RTI Diabetes Cost-Effectiveness Model to run a simulation on the program effectiveness. We estimated incremental health benefits in quality-adjusted life years (QALYs) and costs using an established simulation model adapted to the German context, from a healthcare system and societal perspective. The cost-effectiveness of the program was measured by incremental cost-effectiveness ratios (ICERs) in cost per QALY. We projected the number of type 2 diabetes cases prevented by participation rate if the program was implemented nationwide.Results The lifestyle program would result to more QALYs and higher costs. The lifetime ICERs were 14 690€ (35–54 years old) and 14 372€ (55–74 years old) from a healthcare system perspective and cost saving (ICER=−3805€) and cost-effective (ICER=4579€), respectively, from a societal perspective. A total of 10 527 diabetes cases would be prevented over lifetime if the program was offered to all eligible people nationwide and 25% of those would participate in the program.Conclusions Implementing the lifestyle intervention for people with HbA1c from 6.0% to 6.4% could be a cost-effective at standard willingness to pay level strategy for type 2 diabetes prevention. The intervention in the younger cohort could be cost saving from a societal perspective. The successful implementation of a lifestyle-based diabetes prevention program could be an important component of a successful National Diabetes Strategy in Germany.
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spelling doaj-art-f3f8c9b81ca9406fa7fedcf4ef7bf3972025-08-20T02:49:07ZengBMJ Publishing GroupBMJ Open Diabetes Research & Care2052-48972024-10-0112510.1136/bmjdrc-2024-004382National health and economic impact of a lifestyle program to prevent type 2 diabetes mellitus in Germany: a simulation studyPing Zhang0Andrea Icks1Michael Laxy2Karl Emmert-Fees3Katherine Ogurtsova4Charalabos-Markos Dintsios5Department of Social Medicine and Health Management, Public Health School, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaInstitute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, GermanyGerman Center for Diabetes Research, Neuherberg, GermanyGerman Center for Diabetes Research, Neuherberg, GermanyGerman Center for Diabetes Research, Neuherberg, GermanyInstitute for Health Services Research and Health Economics, Heinrich Heine University Düsseldorf, Dusseldorf, GermanyIntroduction To examine the long-term health and economic impact of a lifestyle diabetes prevention program in people with high risk of developing type 2 diabetes in Germany.Research design and methods We assessed the lifetime cost-effectiveness of a 2-year pragmatic lifestyle program for preventing type 2 diabetes targeting German adults aged 35–54 and 55–74 years old with hemoglobin A1c (HbA1c) from 6.0% to 6.4%. We used the Centers for Disease Control and Prevention RTI Diabetes Cost-Effectiveness Model to run a simulation on the program effectiveness. We estimated incremental health benefits in quality-adjusted life years (QALYs) and costs using an established simulation model adapted to the German context, from a healthcare system and societal perspective. The cost-effectiveness of the program was measured by incremental cost-effectiveness ratios (ICERs) in cost per QALY. We projected the number of type 2 diabetes cases prevented by participation rate if the program was implemented nationwide.Results The lifestyle program would result to more QALYs and higher costs. The lifetime ICERs were 14 690€ (35–54 years old) and 14 372€ (55–74 years old) from a healthcare system perspective and cost saving (ICER=−3805€) and cost-effective (ICER=4579€), respectively, from a societal perspective. A total of 10 527 diabetes cases would be prevented over lifetime if the program was offered to all eligible people nationwide and 25% of those would participate in the program.Conclusions Implementing the lifestyle intervention for people with HbA1c from 6.0% to 6.4% could be a cost-effective at standard willingness to pay level strategy for type 2 diabetes prevention. The intervention in the younger cohort could be cost saving from a societal perspective. The successful implementation of a lifestyle-based diabetes prevention program could be an important component of a successful National Diabetes Strategy in Germany.https://drc.bmj.com/content/12/5/e004382.full
spellingShingle Ping Zhang
Andrea Icks
Michael Laxy
Karl Emmert-Fees
Katherine Ogurtsova
Charalabos-Markos Dintsios
National health and economic impact of a lifestyle program to prevent type 2 diabetes mellitus in Germany: a simulation study
BMJ Open Diabetes Research & Care
title National health and economic impact of a lifestyle program to prevent type 2 diabetes mellitus in Germany: a simulation study
title_full National health and economic impact of a lifestyle program to prevent type 2 diabetes mellitus in Germany: a simulation study
title_fullStr National health and economic impact of a lifestyle program to prevent type 2 diabetes mellitus in Germany: a simulation study
title_full_unstemmed National health and economic impact of a lifestyle program to prevent type 2 diabetes mellitus in Germany: a simulation study
title_short National health and economic impact of a lifestyle program to prevent type 2 diabetes mellitus in Germany: a simulation study
title_sort national health and economic impact of a lifestyle program to prevent type 2 diabetes mellitus in germany a simulation study
url https://drc.bmj.com/content/12/5/e004382.full
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