Cost-effectiveness of the SLIMMER diabetes prevention intervention in Dutch primary health care: Economic evaluation from a randomised controlled trial

G. Duijzer, A.J. Bukman, A. Meints-Groenveld, A. Haveman-Nies, S.C. Jansen, J. Heinrich, G.J. Hiddink, E.J.M. Feskens, G.A. De Wit

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

© 2019 The Author(s).Background: Although evidence is accumulating that lifestyle modification may be cost-effective in patients with prediabetes, information is limited on the cost-effectiveness of interventions implemented in public health and primary health care settings. Evidence from well-conducted pragmatic trials is needed to gain insight into the realistic cost-effectiveness of diabetes prevention interventions in real-world settings. The aim of this study is to assess the cost-effectiveness of the SLIMMER lifestyle intervention targeted at patients at high risk of developing type 2 diabetes compared with usual health care in a primary care setting in the Netherlands. Methods: Three hundred and sixteen high-risk subjects were randomly assigned to the SLIMMER lifestyle intervention or to usual health care. Costs and outcome assessments were performed at the end of the intervention (12 months) and six months thereafter (18 months). Costs were assessed from a societal perspective. Patients completed questionnaires to assess health care utilisation, participant out-of-pocket costs, and productivity losses. Quality Adjusted Life Years (QALY) were calculated based on the SF-36 questionnaire. Cost-effectiveness planes and acceptability curves were generated using bootstrap analyses. Results: The cost-effectiveness analysis showed that the incremental costs of the SLIMMER lifestyle intervention were €547 and that the incremental effect was 0.02 QALY, resulting in an incremental cost-effectiveness ratio (ICER) of €28,094/QALY. When cost-effectiveness was calculated from a health care perspective, the ICER decreased to €13,605/QALY, with a moderate probability of being cost-effective (56% at a willingness to pay, WTP, of €20,000/QALY and 81% at a WTP of €80,000/QALY). Conclusions: The SLIMMER lifestyle intervention to prevent type 2 diabetes had a low to moderate probability of being cost-effective, depending on the perspective taken.
Original languageEnglish
Article number824
JournalBMC health services research
Volume19
Issue number1
DOIs
Publication statusPublished - 11 Nov 2019
Externally publishedYes

Funding

This work was supported by the Netherlands Organization for Health Research and Development ZonMw (87600048, 20400.7003); and the Dutch Diabetes Research Foundation (2011.15.1462). The Netherlands Organization for Health Research and Development ZonMw and the Dutch Diabetes Research Foundation had no role in the design of the study; collection, analysis, and interpretation of data; in writing the manuscript; and in submitting the article for publication.

FundersFunder number
Netherlands Organization for Health Research and Development ZonMW87600048, 20400.7003
Diabetes Fonds2011.15.1462

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