Evaluating the cost-effectiveness of lifestyle modification versus metformin therapy for the prevention of diabetes in Singapore.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
Read Online Read More Add to Saved list
  • Author(s): Png ME;Png ME; Yoong JS; Yoong JS
  • Source:
    PloS one [PLoS One] 2014 Sep 09; Vol. 9 (9), pp. e107225. Date of Electronic Publication: 2014 Sep 09 (Print Publication: 2014).
  • Publication Type:
    Journal Article; Research Support, Non-U.S. Gov't
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
    • Publication Information:
      Original Publication: San Francisco, CA : Public Library of Science
    • Subject Terms:
      Behavior Therapy/*economics ; Cost-Benefit Analysis/*economics ; Diabetes Mellitus, Type 2/*economics ; Hypoglycemic Agents/*economics ; Metformin/*economics; Behavior Therapy/methods ; Diabetes Mellitus, Type 2/drug therapy ; Diabetes Mellitus, Type 2/prevention & control ; Health Care Costs ; Humans ; Hypoglycemic Agents/therapeutic use ; Life Style ; Metformin/therapeutic use ; Prediabetic State ; Quality of Life ; Quality-Adjusted Life Years ; Singapore
    • Abstract:
      Background: In Singapore, as diabetes is an increasingly important public health issue, the cost-effectiveness of pursuing lifestyle modification programs and/or alternative prevention strategies is of critical importance for policymakers. While the US Diabetes Prevention Program (DPP) compared weight loss through lifestyle modification with oral treatment of diabetes drug metformin to prevent/delay the onset of type 2 diabetes in pre-diabetic subjects, no data on either the actual or potential cost effectiveness of such a program is available for East or South-east Asian populations. This study estimates the 3-year cost-effectiveness of lifestyle modification and metformin among pre-diabetic subjects from a Singapore health system and societal perspective.
      Methodology: Cost effectiveness was analysed from 2010-2012 using a decision-based model to estimate the rates of getting diabetes, healthcare costs and health-related quality of life. Cost per quality-adjusted life year (QALY) was estimated using costs relevant to the time horizon of the study from Singapore. All costs are expressed in 2012 US dollars.
      Principal Findings: The total economic cost for non-diabetic subjects from the societal perspective was US$25,867, US$28,108 and US$26,177 for placebo, lifestyle modification and metformin intervention respectively. For diabetic patients, the total economic cost from the societal perspective was US$32,921, US$35,163 and US$33,232 for placebo, lifestyle modification and metformin intervention respectively. Lifestyle modification relative to placebo is likely to be associated with an incremental cost per QALY gained at US$36,663 while that of metformin intervention is likely to be US$6,367 from a societal perspective.
      Conclusion: Based on adaptation of the DPP data to local conditions, both lifestyle modification and metformin intervention are likely to be cost-effective and worth implementing in Singapore to prevent or delay the onset of type 2 diabetes. However, the cost of lifestyle modification from the societal perspective would have to be reduced in order to match the cost-effectiveness of metformin intervention.
    • Comments:
      Erratum in: PLoS One. 2015;10(3):e0120831. (PMID: 25774690)
    • References:
      Diabetes Care. 2007 Oct;30(10):2548-52. (PMID: 17670917)
      Diabetes Care. 2005 Apr;28(4):888-94. (PMID: 15793191)
      Prim Care Diabetes. 2012 Jul;6(2):109-21. (PMID: 22153888)
      Pharmacoeconomics. 2004;22(3):149-64. (PMID: 14871163)
      Health Econ. 1998 Sep;7(6):481-93. (PMID: 9809707)
      Diabetes Care. 2003 Sep;26(9):2518-23. (PMID: 12941712)
      J Public Health Med. 1998 Mar;20(1):16-22. (PMID: 9602443)
      JAMA. 1991 Aug 14;266(6):810-5. (PMID: 1907670)
      Diabetes Care. 2013 Apr;36(4):1033-46. (PMID: 23468086)
      Diabetes Res Clin Pract. 2017 Jun;128:40-50. (PMID: 28437734)
      Diabetes Care. 2012 Apr;35(4):723-30. (PMID: 22442395)
      Diabetes Care. 2003 Jan;26(1):36-47. (PMID: 12502656)
      PLoS Negl Trop Dis. 2011 Dec;5(12):e1426. (PMID: 22206028)
      Int J Equity Health. 2012 Aug 16;11:44. (PMID: 22894180)
      N Engl J Med. 2002 Feb 7;346(6):393-403. (PMID: 11832527)
      Health Econ. 2001 Dec;10(8):779-87. (PMID: 11747057)
      J Contin Educ Health Prof. 2008 Spring;28(2):99-102. (PMID: 18521877)
      BMJ Open Diabetes Res Care. 2014 Jun 11;2(1):e000012. (PMID: 25452860)
    • Accession Number:
      0 (Hypoglycemic Agents)
      9100L32L2N (Metformin)
    • Publication Date:
      Date Created: 20140910 Date Completed: 20150528 Latest Revision: 20240323
    • Publication Date:
      20240323
    • Accession Number:
      PMC4159303
    • Accession Number:
      10.1371/journal.pone.0107225
    • Accession Number:
      25203633