Assessing the potential return on investment of the proposed UK NHS diabetes prevention programme in different population subgroups: an economic evaluation
dc.contributor.author | Thomas, C | |
dc.contributor.author | Sadler, SE | |
dc.contributor.author | Breeze, P | |
dc.contributor.author | Squires, H | |
dc.contributor.author | Gillett, M | |
dc.contributor.author | Brennan, A | |
dc.date.accessioned | 2017-10-06T08:09:46Z | |
dc.date.issued | 2017-08-21 | |
dc.description.abstract | Objectives To evaluate potential return on investment of the National Health Service Diabetes Prevention Programme (NHS DPP) in England and estimate which population subgroups are likely to benefit most in terms of cost-effectiveness, cost-savings and health benefits. Design Economic analysis using the School for Public Health Research Diabetes Prevention Model. Setting England 2015–2016. Population Adults aged ≥16 with high risk of type 2 diabetes (HbA1c 6%–6.4%). Population subgroups defined by age, sex, ethnicity, socioeconomic deprivation, baseline body mass index, baseline HbA1c and working status. Interventions The proposed NHS DPP: an intensive lifestyle intervention focusing on dietary advice, physical activity and weight loss. Comparator: no diabetes prevention intervention. Main outcome measures Incremental costs, savings and return on investment, quality-adjusted life-years (QALYs), diabetes cases, cardiovascular cases and net monetary benefit from an NHS perspective. Results Intervention costs will be recouped through NHS savings within 12 years, with net NHS saving of £1.28 over 20 years for each £1 invested. Per 100 000 DPP interventions given, 3552 QALYs are gained. The DPP is most cost-effective and cost-saving in obese individuals, those with baseline HbA1c 6.2%–6.4% and those aged 40–74. QALY gains are lower in minority ethnic and low socioeconomic status subgroups. Probabilistic sensitivity analysis suggests that there is 97% probability that the DPP will be cost-effective within 20 years. NHS savings are highly sensitive to intervention cost, effectiveness and duration of effect. Conclusions The DPP is likely to be cost-effective and cost-saving under current assumptions. Prioritising obese individuals could create the most value for money and obtain the greatest health benefits per individual targeted. Low socioeconomic status or ethnic minority groups may gain fewer QALYs per intervention, so targeting strategies should ensure the DPP does not contribute to widening health inequalities. Further evidence is needed around the differential responsiveness of population subgroups to the DPP. | en_GB |
dc.description.sponsorship | This abstract presents independent research commissioned and funded by Public Health England (PHE) with support from NHS England, Diabetes UK and the Department of Health. Model development was funded by the National Institute for Health Research (NIHR)’s School for Public Health Research (SPHR). The views expressed are those of the authors and not necessarily those of PHE, NHS England, Diabetes UK, the NIHR or the Department of Health. | en_GB |
dc.identifier.citation | Vol. 7 (8), article e014953 | en_GB |
dc.identifier.doi | 10.1136/bmjopen-2016-014953 | |
dc.identifier.uri | http://hdl.handle.net/10871/29715 | |
dc.language.iso | en | en_GB |
dc.publisher | BMJ Publishing Group | en_GB |
dc.rights | © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. Open Access This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. | en_GB |
dc.title | Assessing the potential return on investment of the proposed UK NHS diabetes prevention programme in different population subgroups: an economic evaluation | en_GB |
dc.type | Article | en_GB |
dc.date.available | 2017-10-06T08:09:46Z | |
dc.identifier.issn | 2044-6055 | |
dc.description | This is the final version of the article. Available from BMJ Publishing Group via the DOI in this record. | en_GB |
dc.identifier.journal | BMJ Open | en_GB |
dc.rights.uri | https://creativecommons.org/licenses/by-nc/4.0/ |
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Except where otherwise noted, this item's licence is described as © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. Open Access This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.