scholarly journals Cost and Cost-effectiveness of Large-scale Screening for Type 1 Diabetes in Colorado

Diabetes Care ◽  
2020 ◽  
Vol 43 (7) ◽  
pp. 1496-1503 ◽  
Author(s):  
R. Brett McQueen ◽  
Cristy Geno Rasmussen ◽  
Kathleen Waugh ◽  
Brigitte I. Frohnert ◽  
Andrea K. Steck ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Cost Effectiveness ◽  
Large Scale ◽  
Large Scale Screening

scholarly journals Cost and Cost-Effectiveness of Large Scale Screening for Type 1 Diabetes in Colorado

2020 ◽  
Author(s):  
R. Brett McQueen ◽  
Cristy Geno ◽  
Kathleen Waugh ◽  
Brigitte I. Frohnert ◽  
Andrea K. Steck ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Cost Effectiveness ◽  
Large Scale ◽  
Screening Program ◽  
Lifetime Cost ◽  
Routine Screening ◽  
Diabetes Screening ◽  
Potential Cost ◽  
Lifetime Horizon

<i>Objective: </i>To assess the costs and project the potential lifetime cost-effectiveness of the ongoing Autoimmunity Screening for Kids (ASK) Program, a large-scale pre-symptomatic type 1 diabetes screening program for children and adolescents in the metro Denver region. <p><i>Research Design and Methods</i>: We report the resource utilization, costs, and effectiveness measures from the ongoing ASK program as compared to usual care (i.e., no screening). Additionally, we report a practical screening scenario by including utilization and costs relevant to routine screening in clinical practice. Finally, we project the potential cost-effectiveness of ASK and routine screening by identifying clinical benchmarks (i.e., DKA events avoided, HbA1c improvements vs. no screening) needed to meet value thresholds of $50,000 to $150,000 per quality-adjusted life year (QALY) gained over a lifetime horizon. </p> <p><i>Results</i>: Cost per case detected was $4,700 for ASK screening and $14,000 for routine screening. To achieve value thresholds of $50,000 to $150,000 per QALY gained, screening costs would need to be offset by cost savings through 20% reductions in DKA events at diagnosis in addition to 0.1% (1.1 mmol/mol) improvements in HbA1c over a lifetime as compared to no screening for patients that develop type 1 diabetes. Value thresholds were not met from avoiding DKA events alone in either scenario. </p> <p><i>Conclusions</i>: Pre-symptomatic type 1 diabetes screening may be cost-effective in areas with high prevalence of DKA and infrastructure facilitating screening and monitoring if the benefits of avoiding DKA events and improved HbA1c persist over long-run time horizons. As more data are collected from ASK, the model will be updated with direct evidence on screening effects.</p>

scholarly journals Cost and Cost-Effectiveness of Large Scale Screening for Type 1 Diabetes in Colorado

2020 ◽  
Author(s):  
R. Brett McQueen ◽  
Cristy Geno ◽  
Kathleen Waugh ◽  
Brigitte I. Frohnert ◽  
Andrea K. Steck ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Cost Effectiveness ◽  
Large Scale ◽  
Screening Program ◽  
Lifetime Cost ◽  
Routine Screening ◽  
Diabetes Screening ◽  
Potential Cost ◽  
Lifetime Horizon

<i>Objective: </i>To assess the costs and project the potential lifetime cost-effectiveness of the ongoing Autoimmunity Screening for Kids (ASK) Program, a large-scale pre-symptomatic type 1 diabetes screening program for children and adolescents in the metro Denver region. <p><i>Research Design and Methods</i>: We report the resource utilization, costs, and effectiveness measures from the ongoing ASK program as compared to usual care (i.e., no screening). Additionally, we report a practical screening scenario by including utilization and costs relevant to routine screening in clinical practice. Finally, we project the potential cost-effectiveness of ASK and routine screening by identifying clinical benchmarks (i.e., DKA events avoided, HbA1c improvements vs. no screening) needed to meet value thresholds of $50,000 to $150,000 per quality-adjusted life year (QALY) gained over a lifetime horizon. </p> <p><i>Results</i>: Cost per case detected was $4,700 for ASK screening and $14,000 for routine screening. To achieve value thresholds of $50,000 to $150,000 per QALY gained, screening costs would need to be offset by cost savings through 20% reductions in DKA events at diagnosis in addition to 0.1% (1.1 mmol/mol) improvements in HbA1c over a lifetime as compared to no screening for patients that develop type 1 diabetes. Value thresholds were not met from avoiding DKA events alone in either scenario. </p> <p><i>Conclusions</i>: Pre-symptomatic type 1 diabetes screening may be cost-effective in areas with high prevalence of DKA and infrastructure facilitating screening and monitoring if the benefits of avoiding DKA events and improved HbA1c persist over long-run time horizons. As more data are collected from ASK, the model will be updated with direct evidence on screening effects.</p>

The cost-effectiveness of the KIds in control of food structured education programme for adolescents with type 1 diabetes

2015 ◽  
Author(s):  
Hasan Basirir ◽  
Alan Brennan ◽  
Richard Jacques ◽  
Daniel Pollard ◽  
Katherine Stevens ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Cost Effectiveness ◽  
Education Programme ◽  
Structured Education ◽  
The Cost

scholarly journals Cost-effectiveness of home versus hospital management of children at onset of type 1 diabetes: the DECIDE randomised controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e043523
Author(s):  
Zoe McCarroll ◽  
Julia Townson ◽  
Timothy Pickles ◽  
John W Gregory ◽  
Rebecca Playle ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Cost Effectiveness ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Case Analysis ◽  
Base Case ◽  
Base Case Analysis ◽  
Home Management ◽  
Randomised Controlled

ObjectiveThe aim of this economic evaluation was to assess whether home management could represent a cost-effective strategy in the patient pathway of type 1 diabetes (T1D). This is based on the Delivering Early Care In Diabetes Evaluation trial (ISRCTN78114042), which compared home versus hospital management from diagnosis in childhood diabetes and found no statistically significant difference in glycaemic control at 24 months.DesignCost-effectiveness analysis alongside a randomised controlled trial.SettingEight paediatric diabetes centres in England, Wales and Northern Ireland.Participants203 clinically well children aged under 17 years, with newly diagnosed T1D and their carers.Outcome measuresThe base-case analysis adopted n National Health Service (NHS) perspective. A scenario analysis assessed costs from a broader societal perspective. The incremental cost-effectiveness ratio (ICER), expressed as cost per mmol/mol reduction in glycated haemoglobin (HbA1c), was based on the mean difference in costs between the home and hospital groups, divided by mean differences in effectiveness (HbA1c). Uncertainty was considered in terms of the probability of cost-effectiveness.ResultsAt 24 months postintervention, the base-case analysis showed a difference in costs between home and hospital, in favour of home management (mean difference −£2,217; 95% CI −£2825 to −£1,609; p<0.001). Home care dominated, with an ICER of £7434 (saved) per mmol/mol reduction of HbA1c. The results of the scenario analysis also favoured home management. The greatest driver of cost differences was hospitalisation during the initiation period.ConclusionsHome management from diagnosis of children with T1D who are medically stable represents a less costly approach for the NHS in the UK, without impacting clinical effectiveness.Trial registration numberISRCTN78114042.

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