TY - JOUR
T1 - Cost-effectiveness of the psycho-educational blended (group and online) intervention HypoAware compared with usual care for people with Type 1 and insulin-treated Type 2 diabetes with problematic hypoglycaemia
T2 - analyses of a cluster-randomized controlled trial
AU - de Wit, M.
AU - Rondags, S. M.P.A.
AU - van Tulder, M. W.
AU - Snoek, F. J.
AU - Bosmans, J. E.
PY - 2018/2/1
Y1 - 2018/2/1
N2 - Aims: To evaluate the cost-effectiveness of HypoAware, a blended (group and online) psycho-educational intervention based on the evidence-based Blood Glucose Awareness Training, in comparison with usual care in people with Type 1 and Type 2 diabetes with a high risk of severe hypoglycaemia. Methods: We performed an economic evaluation, from a societal and healthcare perspective, that used data from a 6-month, multicentre, cluster-randomized controlled trial (n = 137). Results: The proportion of people with at least one severe hypoglycaemic event per 6 months was 0.22 lower (95% CI –0.39 to –0.06) and the proportion of people with impaired hypoglycaemia awareness was 0.16 lower (95% CI –0.34 to 0.02) in the HypoAware group. There was no difference in quality-adjusted life-years (–0.0; 95% CI –0.05 to 0.05). The mean total societal costs in the HypoAware group were EUR708 higher than in the usual care group (95% CI –951 to 2298). The mean incremental cost per severe hypoglycaemic event prevented was EUR2,233. At a willingness-to-pay threshold of EUR20,000 per event prevented, the probability that HypoAware was cost-effective in comparison with usual care was 54% from a societal perspective and 55% from a healthcare perspective. For quality-adjusted life-years the incremental cost-effectiveness ratio was EUR119,360/quality-adjusted life-year gained and the probability of cost-effectiveness was low at all ceiling ratios. Conclusions: Based on the present study, we conclude that HypoAware is not cost-effective compared to usual care. Further research in less well-resourced settings and more severely affected patients is warranted. (Clinical Trials Registry no: Dutch Trial Register NTR4538.).
AB - Aims: To evaluate the cost-effectiveness of HypoAware, a blended (group and online) psycho-educational intervention based on the evidence-based Blood Glucose Awareness Training, in comparison with usual care in people with Type 1 and Type 2 diabetes with a high risk of severe hypoglycaemia. Methods: We performed an economic evaluation, from a societal and healthcare perspective, that used data from a 6-month, multicentre, cluster-randomized controlled trial (n = 137). Results: The proportion of people with at least one severe hypoglycaemic event per 6 months was 0.22 lower (95% CI –0.39 to –0.06) and the proportion of people with impaired hypoglycaemia awareness was 0.16 lower (95% CI –0.34 to 0.02) in the HypoAware group. There was no difference in quality-adjusted life-years (–0.0; 95% CI –0.05 to 0.05). The mean total societal costs in the HypoAware group were EUR708 higher than in the usual care group (95% CI –951 to 2298). The mean incremental cost per severe hypoglycaemic event prevented was EUR2,233. At a willingness-to-pay threshold of EUR20,000 per event prevented, the probability that HypoAware was cost-effective in comparison with usual care was 54% from a societal perspective and 55% from a healthcare perspective. For quality-adjusted life-years the incremental cost-effectiveness ratio was EUR119,360/quality-adjusted life-year gained and the probability of cost-effectiveness was low at all ceiling ratios. Conclusions: Based on the present study, we conclude that HypoAware is not cost-effective compared to usual care. Further research in less well-resourced settings and more severely affected patients is warranted. (Clinical Trials Registry no: Dutch Trial Register NTR4538.).
KW - Journal Article
UR - http://www.scopus.com/inward/record.url?scp=85040679447&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85040679447&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/dme.13548
DO - https://doi.org/10.1111/dme.13548
M3 - Article
C2 - 29150861
SN - 0742-3071
VL - 35
SP - 214
EP - 222
JO - Diabetic medicine
JF - Diabetic medicine
IS - 2
ER -