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Cost-effectiveness of population-based, community, workplace and individual policies for diabetes prevention in the UK

Breeze, PR; Thomas, C; Squires, H; Brennan, A; Greaves, C; Diggle, P; Brunner, E; ... Chilcott, J; + view all (2017) Cost-effectiveness of population-based, community, workplace and individual policies for diabetes prevention in the UK. Diabetic Medicine , 34 (8) pp. 1136-1144. 10.1111/dme.13349. Green open access

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Abstract

Aim: To analyse the cost-effectiveness of different interventions for Type 2 diabetes prevention within a common framework. Methods: A micro-simulation model was developed to evaluate the cost-effectiveness of a range of diabetes prevention interventions including: (1) soft drinks taxation; (2) retail policy in socially deprived areas; (3) workplace intervention; (4) community-based intervention; and (5) screening and intensive lifestyle intervention in individuals with high diabetes risk. Within the model, individuals follow metabolic trajectories (for BMI, cholesterol, systolic blood pressure and glycaemia); individuals may develop diabetes, and some may exhibit complications of diabetes and related disorders, including cardiovascular disease, and eventually die. Lifetime healthcare costs, employment costs and quality-adjusted life-years are collected for each person. Results: All interventions generate more life-years and lifetime quality-adjusted life-years and reduce healthcare spending compared with doing nothing. Screening and intensive lifestyle intervention generates greatest lifetime net benefit (£37) but is costly to implement. In comparison, soft drinks taxation or retail policy generate lower net benefit (£11 and £11) but are cost-saving in a shorter time period, preferentially benefit individuals from deprived backgrounds and reduce employer costs. Conclusion: The model enables a wide range of diabetes prevention interventions to be evaluated according to cost-effectiveness, employment and equity impacts over the short and long term, allowing decision-makers to prioritize policies that maximize the expected benefits, as well as fulfilling other policy targets, such as addressing social inequalities.

Type: Article
Title: Cost-effectiveness of population-based, community, workplace and individual policies for diabetes prevention in the UK
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/dme.13349
Publisher version: http://doi.org/10.1111/dme.13349
Language: English
Additional information: This work is licensed under a Creative Commons Attribution 4.0 (CC BY-NC 4.0) International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
URI: https://discovery.ucl.ac.uk/id/eprint/1549809
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